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HESI Mr. Fenske Respiratory
Get Quizlet's official HESI A2 - 1 term, 1 practice question, 1 full practice test
Terms in this set (20)
You quickly perform an assessment. You notice that Mr. Fenske's shoulders rise with each inspiration. This probably indicates that he is:
B. using his accessory muscles to breathe
You also note the rounded, rigid shape of Mr. Fenske's chest wall. This chest wall appearance is typical of patients with emphysema. You document your assessment of Mr. Fenske's chest as:
C. barrel chest
As you observe Mr. Fenske, you recall that chronic obstructive pulmonary disease (COPD) is generally characterized by progressive reduction in bronchial airflow. The underlying pathophysiology may involve:
Select all that apply
A. air trapping in distal air spaces
B. airway inflammation and excessive mucous
Which of the following clinical signs/symptoms are common in persons with chronic obstructive pulmonary disease (COPD)?
A. Increasing shortness of breath
You've cared for many patients with chronic obstructive pulmonary disease (COPD), and have learned that:
D. COPD is a progressive disease
Over time, persons with chronic obstructive pulmonary disease (COPD) may develop cardiac complications. Which of the following may occur as a complication of COPD?
B. Right ventricular heart failure
Your assessment of Mr. Fenske does not reveal signs of right ventricular heart failure. However, you know that signs and symptoms of right ventricular heart failure can include:
B. dependent pedal edema
C. distended neck veins
Oxygen is also ordered for Mr. Fenske, at a fixed concentration of 40%. To administer a fixed concentration of oxygen, which of the following oxygen delivery devices is used?
D. Venturi mask
Proventil (albuterol) is a beta-adrenergic agonist; Atrovent (ipratropium) is an anticholinergic drug. Both of these medications will help alleviate Mr. Fenske's respiratory distress through which action?
Besides bronchodilator treatments, chest physiotherapy (PT) is also ordered for Mr. Fenske. In which sequence should these treatments be implemented?
A. Bronchodilator, chest PT
In some patients with chronic obstructive pulmonary disease (COPD), an increased production of red blood cells occurs as compensation for chronic hypoxia. This increase in red blood cell count is called compensatory or secondary:
Although Mr. Fenske's respiratory status has improved, you continue to observe him for signs of hypoxia. When assessing Mr. Fenske for hypoxia, you observe for:
Pulmonary function tests are done with persons with chronic obstructive pulmonary disease (COPD) to evaluate the severity of disease and establish a prognosis. In a person with COPD, which test is the best predictor of prognosis?
C. Forced expiratory volume in 1 second (FEV1)
Mr. Fenske is now taking Proventil (albuterol) and Atrovent (ipratropium) by inhaler. A steroid medication is added, also to be administered as an inhalant. You advise Mr. Fenske that:
A. "This medication will decrease the inflammation in your air passages."
Which of the following factors, identified as part of Mr. Fenske's health history, may have predisposed him to emphysema?
A. History of smoking two packs per day for 40 years
B. A family history of chronic obstructive pulmonary disease (COPD)
D. Employment as a carpenter
You reinforce the technique for using a metered-dose inhaler (MDI) with Mr. Fenske. Which of the following describes optimal technique for using a MDI?
C. Exhale completely -- begin inspiration -- activate MDI -- slow, deep breath
To help mobilize and remove respiratory secretions, you teach Mr. Fenske the procedure for huff coughing. Huff coughing involves:
C. coughing on exhalation while saying "huff"
Prior to Mr. Fenske being discharged home, you evaluate his understanding of his medications. Which of the following statements by Mr. Fenske indicates a need for further teaching?
A. "If I get very short of breath, I can use either the Proventil (albuterol) inhaler or the Atrovent (ipratropium) inhaler to quickly help my breathing."
Which of the following instructions should you include in your discharge teaching plan for Mr. Fenske?
A. Avoid persons with upper respiratory infections
C. Practice pursed lip breathing
F. Clean respiratory equipment daily
The single most important intervention to halt the progression of chronic obstructive pulmonary disease (COPD) in a person with COPD is smoking cessation. How can you most effectively help to accomplish this?
B. Recommend that the person consider a behavior modification program
C. Encourage the person to talk to his physician about prescribing a nicotine replacement
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