NCLEX Style Questions about the Patient with COPD
1. The deepest lung tissues are sterile even though atmospheric air (containing micro-organisms, particulate and other toxins) is the source of alveolar air
A. True
B. False
2. The student nurse is discussing with the patient incentives for him to stop smoking. All of the incentives/statements below are correct except:
A. Smoking cessation will make you less susceptible to lung infections.
B. Eliminating exposure of airways to cigarette smoke will decrease inflammation and may reduce chronic cough.
C. After eliminating tobacco use the patient's airways will undergo "reverse remodeling" and become almost normal.
D. If he stops using cigarettes his wife and grand-children will have less exposure to second hand smoke.
3. The student knows that long-term tobacco use destroys pulmonary architecture increasing the work of breathing. An assessment he would expect to see while observing a COPD patient with a 100 pack year smoking history is
A. A inspiratory phase that is 3 times longer than the expiratory phase of the respiratory cycle.
B. Use of abdominal muscles to breath in
C. Use of sternoclaidomastoid and trapezius muscles to breath in
D. Tachypnea
4. Refractory hypoxia is due to
A. alveolar hypoventilation
B. cor pulmonale
C. ventilation of inadequately perfused alveoli
D. perfusion of inadequately ventilated alveoli
5. The nurse looks at Mr. C's laboratory data and notes that the serum HCO3 is very elevated. For this reason the nurse can conclude that
A. The patient has had chronic alveolar hypoventilation and CO2 retention for a long time.
B. The patient has underlying renal disease
C. The patient has a bacterial infection
D. The patient should lay off the antacids he's always using
6. The patient with COPD exascerbation is sent to the telemetry floor for close observation. He is hooked up to the monitor because
A. With his prolonged QT interval, the patient is at increased risk of Torsades de pointe.
B. The most common arrhythmia seen among patients with COPD is premature atrial contractions
C. The monitor will clearly demonstrate Mr. C's right axis deviation
D. The patient has left sided heart failure which is very common among patients with COPD
7. The nurse checks Mr. Culver's admission chemistries. She notices that his serum bicarbonate is very elevated. This tells the nurse that
A. The patient has acute respiratory alkalosis
B. His respiratory acidosis is very chronic
C. The patient needs to put more effort into inhaling and exhaling.
D. The patient has a pulmonary infection.
8. The radiologist's reading of the chest x-ray states that Mr. Culver has bibasilar consolidation. When auscultating over the patient's bases the nurse would expect to hear
A. An S3 and S4
B. Vesicular breath sounds
C. Nothing because no air is going in or out of these tissues
D. Broncho-vesicular or bronchial breath sounds
9. Mr. Culver is admitted with "respiratory failure, COPD exacerbation, community acquired pneumonia (CAP)". Which of the following would be the nurse's priority problem statement (nursing diagnosis).
A. RIsk for infection
B. Impaired physical mobility
C. Risk prone behavior
D. Impaired gas exchange
10. An appropriate goal statement for Mr. Culver's principle problem (nursing diagnosis) is...
A. Within 24 hours will walk to the bathroom on supplemental oxygenation (6L/min) without desaturating (below 90%)
B. The patient's antibiotics will be begun promptly according to CAP Core Measures
C. Prior to discharge the patient will understand the relationship between tobacco usage and his respiratory problems.
D. The patient will be given information about long term oxygen therapy
A. True
B. False
2. The student nurse is discussing with the patient incentives for him to stop smoking. All of the incentives/statements below are correct except:
A. Smoking cessation will make you less susceptible to lung infections.
B. Eliminating exposure of airways to cigarette smoke will decrease inflammation and may reduce chronic cough.
C. After eliminating tobacco use the patient's airways will undergo "reverse remodeling" and become almost normal.
D. If he stops using cigarettes his wife and grand-children will have less exposure to second hand smoke.
3. The student knows that long-term tobacco use destroys pulmonary architecture increasing the work of breathing. An assessment he would expect to see while observing a COPD patient with a 100 pack year smoking history is
A. A inspiratory phase that is 3 times longer than the expiratory phase of the respiratory cycle.
B. Use of abdominal muscles to breath in
C. Use of sternoclaidomastoid and trapezius muscles to breath in
D. Tachypnea
4. Refractory hypoxia is due to
A. alveolar hypoventilation
B. cor pulmonale
C. ventilation of inadequately perfused alveoli
D. perfusion of inadequately ventilated alveoli
5. The nurse looks at Mr. C's laboratory data and notes that the serum HCO3 is very elevated. For this reason the nurse can conclude that
A. The patient has had chronic alveolar hypoventilation and CO2 retention for a long time.
B. The patient has underlying renal disease
C. The patient has a bacterial infection
D. The patient should lay off the antacids he's always using
6. The patient with COPD exascerbation is sent to the telemetry floor for close observation. He is hooked up to the monitor because
A. With his prolonged QT interval, the patient is at increased risk of Torsades de pointe.
B. The most common arrhythmia seen among patients with COPD is premature atrial contractions
C. The monitor will clearly demonstrate Mr. C's right axis deviation
D. The patient has left sided heart failure which is very common among patients with COPD
7. The nurse checks Mr. Culver's admission chemistries. She notices that his serum bicarbonate is very elevated. This tells the nurse that
A. The patient has acute respiratory alkalosis
B. His respiratory acidosis is very chronic
C. The patient needs to put more effort into inhaling and exhaling.
D. The patient has a pulmonary infection.
8. The radiologist's reading of the chest x-ray states that Mr. Culver has bibasilar consolidation. When auscultating over the patient's bases the nurse would expect to hear
A. An S3 and S4
B. Vesicular breath sounds
C. Nothing because no air is going in or out of these tissues
D. Broncho-vesicular or bronchial breath sounds
9. Mr. Culver is admitted with "respiratory failure, COPD exacerbation, community acquired pneumonia (CAP)". Which of the following would be the nurse's priority problem statement (nursing diagnosis).
A. RIsk for infection
B. Impaired physical mobility
C. Risk prone behavior
D. Impaired gas exchange
10. An appropriate goal statement for Mr. Culver's principle problem (nursing diagnosis) is...
A. Within 24 hours will walk to the bathroom on supplemental oxygenation (6L/min) without desaturating (below 90%)
B. The patient's antibiotics will be begun promptly according to CAP Core Measures
C. Prior to discharge the patient will understand the relationship between tobacco usage and his respiratory problems.
D. The patient will be given information about long term oxygen therapy