PT 3

45問 • 1年前

問題一覧

A 55-yr-old patient with increasing dyspnea is being evaluated for a possible diagnosis of chronic obstructive pulmonary disease (COPD). When teaching a patient about pulmonary spirometry for this condition, what is the most important question the nurse should ask?

"Have you taken any bronchodilators today?"

A young adult patient with cystic fibrosis (CF) is admitted to the hospital with increased dyspnea. Which intervention should the nurse include in the plan of care?

Perform chest physiotherapy every 4 hours.

A patient in the clinic with cystic fibrosis (CF) reports increased sweating and weakness during the summer months. Which action by the nurse would be most appropriate?

Have the patient add dietary salt to meals.

A young adult female patient with cystic fibrosis (CF) tells the nurse that she is considering getting married and wondering about having children. Which initial response by the nurse is best?

"Would like more information to help you with that decision?"

A patient with chronic obstructive pulmonary disease (COPD) has coarse crackles throughout the lung fields and a chronic, nonproductive cough. Which nursing intervention will be most effective?

Teach the patient to use the Flutter airway clearance device.

The nurse provides dietary teaching for a patient with chronic obstructive pulmonary disease (COPD) who has a low body mass index (BMI). Which patient statement indicates that the teaching has been effective?

"I can have ice cream as a snack every day."

Which instruction should the nurse include in an exercise teaching plan for a patient with chronic obstructive pulmonary disease (COPD)?

"Use the bronchodilator before you start to exercise."

The nurse completes an admission assessment on a patient with asthma. Which information given by patient is indicates a need for a change in therapy?

The patient's only medications are albuterol (Ventolin HFAl) and salmeterol (Serevent).

The nurse takes an admission history on a patient with possible asthma who has new-onset wheezing and shortness of breath. Which information may indicate a need for a change in therapy?

The patient takes propranolol (Inderal) for hypertension.

A patient newly diagnosed with asthma is being discharged. The nurse anticipates including which topic in the discharge teaching?

Self-administration of inhaled corticosteroids

A patient with cystic fibrosis (CF) has blood glucose levels that are consistently between 180 to 250 mg/dL. Which nursing action will the nurse plan to implement?

Teach the patient about administration of insulin.

The nurse assesses a patient with a history of asthma. Which assessment finding indicates that the nurse should take immediate action?

Use of accessory muscles in breathing

A patient who has been experiencing an asthma attack develops bradycardia and a decrease in wheezing. Which action should the nurse take first?

Notify the health care provider.

A patient who is experiencing an acute asthma attack is admitted to the emergency department. Which assessment should the nurse complete first?

Listen to the patient's breath sounds.

Which assessment finding in a patient who has received omalizumab (Xolair) is most important to report immediately to the health care provider?

Flushing and dizziness

The nurse in the emergency department receives arterial blood gas results for four recently admitted patients with obstructive pulmonary disease. The results for which patient will require the most rapid action by the nurse?

pH 7.28, PaCO2 50 mm Hg, and PaO2 58 mm Hg

Which nursing action for a patient with chronic obstructive pulmonary disease (COPD) could the nurse delegate to experienced unlicensed assistive personnel (UAP)?

Obtain O2 saturation using pulse oximetry.

The clinic nurse makes a follow-up telephone call to a patient with asthma. The patient reports having a baseline peak flow reading of 600 L/min, and the current peak flow is 420 L/min. Which action should the nurse take first?

Instruct the patient to use the prescribed albuterol (Ventolin HFA).

The nurse reviews the medication administration record (MAR) for a patient having an acute asthma attack. Which medication should the nurse administer first?

Methylprednisolone (Solu-Medrol) 60 mg IV

The nurse receives a change-of-shift report on the following patients with chronic obstructive pulmonary disease (COPD). Which patient should the nurse assess first?

A patient with a respiratory rate of 38 breaths/min

Which finding in a patient hospitalized with bronchiectasis is most important to report to the health care provider?

Cough productive of bloody, purulent mucus

A patient with asthma has a personal best peak expiratory flow rate (PEFR) of 400 L/min. When explaining the asthma action plan, the nurse will teach the patient that a change in therapy is needed when the PEFR is less than ___ L/minute

320

the patient with acute bronchitis asks if antibiotics will be ordered for the condition. which response is best for the nurse to make?

"antibiotics will be given if the sputum culture indicates your bronchitis is caused by bacteria."

the nurse is assessing the patient with influenza. the patient reports having general malaise and aching muscles over the past 2 weeks. the nurse suspects that the patient may have developed which complication of influenza?

bacterial pneumonia

the purpose of treatment with amantadine (symmetrel)?

To lessen the severity of type A flu symptoms if taken within 48 hours of exposure.

the nurse is caring for a patient with suspected bacterial pneumonia. which finding supports the potential diagnosis?

interstitial inflammation

the 79-year-old patient with bacterial pneumonia becomes increasingly restless, confused, and agitated. the patient's temperature is 100° f, and his pulse, blood pressure, and respirations are elevated since the last assessment 6 hours ago. what action should the nurse take first?

assess the patient's oxygen saturation.

the 75-year-old patient asks the nurse if the pneumovax immunization he took when he was 65 is still protecting him. which reply is most accurate?

"after 6 years, you need a repeat dose of pneumovax for full immunity."

the 75-year-old patient presents to the emergency department with shortness of breath, fatigue, and a dry cough. when information leads the nurse to suspect that this patient should undergo workup for histoplasmosis?

the patient lives on a farm and raises chickens.

the nurse is caring for a 30-year-old american indian female who is taking rifater, a drug containing rifampin, isoniazid, and pyrazinamide. the patient asks how long she will have to take the medication. which response explains when the patient may discontinue the

when three consecutive sputum cultures are negative

the nurse reading a tuberculin skin test (tst) on a new employee who lives in the midwest, is 20-years-old, and has no known history of contact with any people with tuberculosis (tb). the nurse should interpret the reading as positive if the area around the injection site has an induration of how many millimeters?

15 mm

the nurse is assessing a patient with chronic obstructive pulmonary disease (copd). which assessment finding indicates a potential complication and requires the nurse's immediate attention?

distended neck veins

the patient with asthma is prescribed a leukotriene modifier drug, montelukast (singulair). which statement describes an advantage of this medication?

bronchodilation and anti-inflammatory effects

after using a nasal cannula delivery system at 3 l/min, a patient with chronic airflow limitation (cal) changes to asimple face mask. the nasal equipment oxygen was set at 3 l/min. how should the nurse adjust the oxygen flow for the new delivery system?

increase it to 6 l.

the nurse is caring for a patient immediately postoperative after a left pneumonectomy. how should the nurse positionthe patient?

in a leftside-lying position

the nurse is caring for a patient with a closed-chest drainage system with chest tubes. which observation confirms thatthe system is intact and working?

the water level in the water-seal chamber fluctuates.

the nurse is caring for a first-day postoperative thoracotomy patient. the nurse assesses that the level of drainage has not increased over the last 3 hours. after assessing the patient's respiratory status, what should the nurse do next?

check the tubing for kinks.

the nurse is educating a patient who requires daily postural drainage treatments. which statement indicates that the patient understands when and why treatments will be scheduled?

"i will have treatments first thing in the morning to get rid of fluids that have built up over night."

the patient with sleep apnea is fitted with a continuous positive airway pressure (cpap) mask and asks the nurse how this device will help. how should the nurse respond?

"the device delivers constant positive pressure to keep your airway open."

when caring for a patient with acquired immune deficiency syndrome (aids), the nurse is aware that this patient is most at risk for developing which type of pneumonia?

pneumocystis jiroveci

the nurse is educating an asthma patient about proper use of the peak flowmeter. the nurse determines that the patient needs further teaching when observing which action?

the patient breathes deeply through the mouthpiece.

through which method(s) can influenza spread? (select all that apply.)

direct contact, indirect contact, droplets

the home health nurse is making an initial call on a newly diagnosed tuberculosis (tb) patient. the patient lives with his wife and child. which infection control instructions should the nurse include in the teaching plan? (select all that apply.)

place contaminated tissues in sealable plastic bag., wear a mask when in crowds., wash hands frequently., take medications exactly as directed.

the nurse is performing an occupational history as part of the respiratory assessment. which occupation(s) place the patient at increased risk for an occupational lung disorder? (select all that apply.)

a firefighter, a construction contractor, a cotton gin worker

the nurse is caring for a patient with advanced emphysema. which signs are manifestations of this disorder? (select allthat apply.)

productive cough, barrel chest, cyanotic skin tone, dyspnea

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