NCLEX Style Questions about a Patient with Asthma
1. The nurse will conclude the patient is experiencing increased work of breathing when she assess all of the following EXCEPT
A. Use of accessory muscles of breathing and three syllable dyspnea
B. Tripod position, using abdominal muscles and intercostals to breathe out.
C. Production of yellow sputum and a fever
D. Barrel chest and pursed lip breathing.
2. Since impaired oxygenation is an immediate problem for this asthma patient, the nurse wants to keep the patient's % sat above 90. This number is important because
A. The patient is anemic and the %sat has to be high to get oxygen to the tissues.
B. The relationship of %sat to PaO2 is linear so 90% is near the top and is a healthy baseline number.
C. A %sat of less than 90 indicates pulmonary hypertension is developing.
D. If the patient slips below 90% on the oxyhemoglobin curve, small changes in PaO2 will have profound effects on availability of oxygen to the tissues.
3. The patient has been treated for her acute asthma for several hours. The nurse concludes that the treatments are working when the patient's respiratory alkalosis trends toward normal (pH 7.35-7.45) and wheezing is much reduced.
A. True
B. False
4. It is clear when the patient arrives that she has been taking her asthma medications improperly if she was taking them at all. A suitable problem statement/nursing diagnosis for this issue would be : Ineffective family therapeutic regimen management RT medications AEB patient mixing them up and refusing to take some of them.
A. True
B. False
5. Of the drugs given to the patient in the Emergency Room which are given to relax airway smooth muscle. (Pick more than one.)
A. Oxygen
B. Methylprednisone
C. Albuterol
D. MgSO4
6. A patient's ABG's are pH 7.31, PaCO2 55, PaO2 97 (on 100% rebreathing mask.) %sat 100. Which of the statements below are true about this patient? Select more than one.
A. Because the PaCO2 is high and the pH is so low, the patient has respiratory acidosis
B. The nurse would expect that the patient's serum HCO3 (bicarbonate) will be low.
C. Because the PaCO2 is so low, the acidosis is likely metabolic.
D. The values are normal. This patient is fine.
7. When patients have obstructed airways, the pulmonary function test value that usually increases (thereby increasing the work of breathing) is
A. Functional Residual Capacity (FRC)
B. Forced expiratory volume in 1 second (FEV1)
C. Inspiratory reserve capacity (IRC)
D. Vital capacity (VC)
8. After several hours of treatment in the Emergency Room, an asthmatic's respiratory rate has decreased, but his wheezes are much louder and harsher and he is coughing up grey/white-ish sputum. These findings
A. are contradictoroy
B. suggest the patient is beginning to fail
C. tell the nurse the patient is improving.
D. that the patient will need to be admitted.
9. A patient in respiratory distress is only 75% sat on room air. She is put on a 100% rebreathing mask but her %sat only rises to 85%. This is an example of
A. Refractory hypoxia
B. Some of her alveoli are being ventilated by inadequately perfused.
C. Increased work of breathing
D. Infected lung parenchyma
10. The asthmatic young teen discussed in this case study was unwilling to take her medications as prescribed. While in the ER and also to ICU, the nurses' chief aim is to attend to her physiological needs. When she is admitted to the pediatric unit the nurses there may engage her and her parents in discussion about her medications. Age appropriate means of facilitating cooperation from the patient and an honest effort to take her medications as directed would include (you may select all that apply)
A. Get her involved in a support group of asthmatics her age through the American Lung Association.
B. "Contract" with her: If she takes her medications as directed and begins to improve, they will wean her off prednisone (that she thinks makes her "fat" and gives her "zits")
C. Make the school nurse aware of any mid-day medications the patient must take and how often she uses her rescue inhaler.
D. Have the parents tell her if she doesn't take medications as directed, they will not let her get her learner's permit.
A. Use of accessory muscles of breathing and three syllable dyspnea
B. Tripod position, using abdominal muscles and intercostals to breathe out.
C. Production of yellow sputum and a fever
D. Barrel chest and pursed lip breathing.
2. Since impaired oxygenation is an immediate problem for this asthma patient, the nurse wants to keep the patient's % sat above 90. This number is important because
A. The patient is anemic and the %sat has to be high to get oxygen to the tissues.
B. The relationship of %sat to PaO2 is linear so 90% is near the top and is a healthy baseline number.
C. A %sat of less than 90 indicates pulmonary hypertension is developing.
D. If the patient slips below 90% on the oxyhemoglobin curve, small changes in PaO2 will have profound effects on availability of oxygen to the tissues.
3. The patient has been treated for her acute asthma for several hours. The nurse concludes that the treatments are working when the patient's respiratory alkalosis trends toward normal (pH 7.35-7.45) and wheezing is much reduced.
A. True
B. False
4. It is clear when the patient arrives that she has been taking her asthma medications improperly if she was taking them at all. A suitable problem statement/nursing diagnosis for this issue would be : Ineffective family therapeutic regimen management RT medications AEB patient mixing them up and refusing to take some of them.
A. True
B. False
5. Of the drugs given to the patient in the Emergency Room which are given to relax airway smooth muscle. (Pick more than one.)
A. Oxygen
B. Methylprednisone
C. Albuterol
D. MgSO4
6. A patient's ABG's are pH 7.31, PaCO2 55, PaO2 97 (on 100% rebreathing mask.) %sat 100. Which of the statements below are true about this patient? Select more than one.
A. Because the PaCO2 is high and the pH is so low, the patient has respiratory acidosis
B. The nurse would expect that the patient's serum HCO3 (bicarbonate) will be low.
C. Because the PaCO2 is so low, the acidosis is likely metabolic.
D. The values are normal. This patient is fine.
7. When patients have obstructed airways, the pulmonary function test value that usually increases (thereby increasing the work of breathing) is
A. Functional Residual Capacity (FRC)
B. Forced expiratory volume in 1 second (FEV1)
C. Inspiratory reserve capacity (IRC)
D. Vital capacity (VC)
8. After several hours of treatment in the Emergency Room, an asthmatic's respiratory rate has decreased, but his wheezes are much louder and harsher and he is coughing up grey/white-ish sputum. These findings
A. are contradictoroy
B. suggest the patient is beginning to fail
C. tell the nurse the patient is improving.
D. that the patient will need to be admitted.
9. A patient in respiratory distress is only 75% sat on room air. She is put on a 100% rebreathing mask but her %sat only rises to 85%. This is an example of
A. Refractory hypoxia
B. Some of her alveoli are being ventilated by inadequately perfused.
C. Increased work of breathing
D. Infected lung parenchyma
10. The asthmatic young teen discussed in this case study was unwilling to take her medications as prescribed. While in the ER and also to ICU, the nurses' chief aim is to attend to her physiological needs. When she is admitted to the pediatric unit the nurses there may engage her and her parents in discussion about her medications. Age appropriate means of facilitating cooperation from the patient and an honest effort to take her medications as directed would include (you may select all that apply)
A. Get her involved in a support group of asthmatics her age through the American Lung Association.
B. "Contract" with her: If she takes her medications as directed and begins to improve, they will wean her off prednisone (that she thinks makes her "fat" and gives her "zits")
C. Make the school nurse aware of any mid-day medications the patient must take and how often she uses her rescue inhaler.
D. Have the parents tell her if she doesn't take medications as directed, they will not let her get her learner's permit.