COPD Practice NCLEX Test

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fran 1. Which of the following interventions is most helpful in determining the need for oxygen therapy in a client with chronic obstructive pulmonary disease?

• Ask the client to tell the nurse when oxygen is needed
• Assess the client's fatigue level
• Use a pulse oximeter to determine oxygen saturation
• Evaluate the client's hemoglobin level

c

• Oxygen is at the rate of 2 liters/minute through the nasal cannula is prescribed for a client with chronic obstructive pulmonary disease. Which

of the following best describes why the oxygen therapy is maintained at relatively low concentration?

• The oxygen will be lost at the client's nostrils if given at a higher level with a nasal cannula
• The client's long history of respiratory problems indicates that he would unable to absorb oxygen at a higher rate
• The cells in the alveoli are so damaged by the client's long history of respiratory problems that increased oxygen levels and reduced carbon

dioxide levels likely will cause the cells to burst

• The client's respiratory center is used to high carbon dioxide and low oxygen levels that changing these levels may eliminate his stimulus to

breathe d

• For a client with chronic obstructive pulmonary disease who has trouble raising respiratory secretions, which of the following nursing

measures would help reduce the tenacity of secretions?

• Ensuring the client's diet is low in salt
• Ensuring that the client's oxygen therapy is continuous
• Helping the client maintain a high fluid intake
• Keeping the client in a semi-sitting position as much as possible

c

• Clients with chronic obstructive pulmonary disease may be bedridden at home and get a little exercise. Which of the following is a normal

physiologic reaction to prolonged periods of bed rest and inactivity?

• Increased sodium retention
• Increased calcium excretion
• Increased insulin use
• Increased red blood cell production

b

• A client with chronic obstructive disease (COPD) reports steady weight loss and being "too tired from just breathing to eat." Which of the

following nursing diagnosis would be most appropriate when planning nutritional interventions for this client?

A) Imbalanced nutrition: less than body requirements related to fatigue

• Activity intolerance related to dyspnea
• Weight loss related to COPD
• Ineffective breathing pattern related to alveolar hypoventilation

a

• When developing a discharge plan to manage a patient with COPD, the nurse should anticipate that the client will do which of the following?
• Develop respiratory infections easily
• Maintain current status
• Require less supplemental oxygen
• Show permanent improvement

a

• Which of the following outcomes would be appropriate for a client with COPD who has been discharged home?
• The client promises to do purse-lip breathing at home
• The client states actions to reduce pain
• The client states that he will use oxygen via a nasal cannula at 5 L/min
• The client agrees to call the physician f dyspnea on exertion increases

d

• Which of the following physical assessment findings would the nurse expect to find in a client with advanced COPD?
• Increased anteroposterior chest diameter
• Underdeveloped neck muscles
• Collapsed neck veins
• Increased chest excursion with respiration

a

• When instructing clients on how to decrease the risk of COPD, the nurse should emphasize which of the following behaviors?
• Participate regularly in aerobic exercises
• Maintain a high protein diet
• Avoid exposure to people with known respiratory infections
• Abstain from cigarette smoking

d

• Which of the following is the primary reason to teach purse-lip breathing to clients with emphysema?
• To promote oxygen intake
• To strengthen the diaphragm
• To strengthen the intercostal muscles
• To promote carbon dioxide elimination

d

• Which of the following is a priority goal for the client with COPD?
• Maintaining functional ability
• Minimizing chest pain
• Increasing carbon dioxide levels in the blood
• Treating infectious agents

a

• A client's arterial blood gas values are as follows: pH 7.31, PaO2 80 mm Hg, PaCO2 65 mm Hg, HCO3 36 mEq/L. Which of the following signs

and symptoms should the nurse expect?

• Cyanosis
• Flushed skin
• Irritability
• Anxiety

b

• When performing postural drainage, which of the following promotes the movement of secretions from the lower to the upper respiratory

tract?

• Friction between the cilia
• Force of gravity
• Sweeping motion of the cilia
• Involuntary muscle contraction

b

• When teaching a client with COPD to conserve energy, the nurse should teach the client to lift objects:
• While inhaling through an open mouth
• While exhaling through pursed lips
• After exhaling but before inhaling
• While taking a deep breath and holding it

b

• The nurse teaches a client with COPD to assess signs and symptoms of right sided heart failure. Which of the following signs and symptoms

should be included in the teaching plan?

• Clubbing of nails
• Hypertension
• Peripheral edema
• Increased appetite

c

• The nurse assesses the respiratory status of a client experiencing an exacerbation of COPD secondary to a upper respiratory tract infection.

Which of the following findings would be expected?

• Normal breath sounds
• Prolonged inspiration
• Normal chest movement
• Coarse crackles and rhonchi

d

• Which of the following blood gas abnormalities should the nurse anticipate in the client with advanced COPD?
• Increased PaCO2
• Increased PaO2
• Increased pH
• Increased oxygen saturation

a

• A client with COPD is experiencing dyspnea and has a low PaO2 level. The nurse plans to administer oxygen as ordered. Which of the

following statements is true concerning oxygen administration to a client with COPD?

• High oxygen concentrations will cause coughing and dyspnea
• High oxygen concentrations may inhibit the hypoxic stimulus to breathe
• Increased oxygen use will cause the client to become dependent on the oxygen
• Administration of oxygen is contraindicated in clients who are using bronchodilators

b