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Adult Health Exam IV questions

Terms in this set (75)

Select all the correct options that represent the pathophysiology of an asthma attack
-The smooth muscle surrounds the alveoli constricts, limiting oxygenation
-Goblet cells within the mucosa lining produce excessive
-The mucosa lining experiences severe inflammation
-Pt exhales too much CO2 d/t hyperventilation experiencing resp. alkalosis
-Goblet cells within the mucosa lining produce excessive
-The mucosa lining experiences severe inflammation
Which of the following assessment finding would help confirm a diagnosis of the client suspected of having asthma?
-Circumoral cyanosis
-Inspiratory and expiratory wheezing
-Increased forced expiration volume
-Normal breath sounds
-Inspiratory and expiratory wheezing
Select all the following that can trigger an asthma attack
-Smoke
-Cockroaches
-Cold, windy weather
-Caffeine
-Smoke
-Cockroaches
-Cold, windy weather
Which statement by the patient demonstrates they understand how to use their peak flow meter device
-The device will help keep my lungs strong so I don't have an asthma attack
- I will use this device at the same time every day
-I will inhale as hard as I can while using the device
-I will notify the MD if my peak flow rate is greater than 90%
- I will use this device at the same time every day
A patient has exercise-induced asthma. What actions can help the patient prevent an attack during exercise? Select all that apply
-Avoid warming up before exercise
-Administer a short-acting beta-blocking after exercise
-Administer a short-acting beta-agonist before exercise
-Avoid exercising when experiencing a respiratory illness
-Administer a short-acting beta-blocking after exercise
-Administer a short-acting beta-agonist before exercise
-Avoid exercising when experiencing a respiratory illness
A patient with asthma showing inspiratory/expiratory wheezes and decrease expiratory volume should be given which meds first?
-Beta-adrenergic blockers
-Bronchodilators
-Inhaled steroids
-Oral steroids
-Bronchodilators
A patient with asthma has respiration 44 and appears to be in respiratory distress. What action should be taken first?
-Take a full medication history
-Apply a cardiac monitor to the client
-Give a bronchodilator by nebulizer
-Provide emotional support to the client
-Give a bronchodilator by nebulizer
The nurse interprets that a client with "barrel chest" has which of the following forms of chronic airflow limitations
-Chronic obstructive bronchitis
-Emphysema
-Bronchial asthma
-Bronchial asthma and bronchitis
-Emphysema
The RN teaches a client with COPD to assess for S/S of right-sided HF. Which s/s would be included in the teaching
-Clubbing of nail beds
-Use diaphragmatic breathing
-Exhale through an open mouth
-Use chest breathing
-Use diaphragmatic breathing
The pt diagnosed with exacerbation of COPD is in respiratory distress. Which intervention should the nurse implement first
-Assist the patient into 90 degree sitting position
-Monitor vs. with the patient sitting upright
-Administer O2 at 6 LPM via nasal canula
-Notify the health care provider about pt's status
-Assist the patient into 90 degree sitting position
Which of the following diets would be most appropriate for a client with COPD?
-Low fat, low cholesterol
-Low-sodium diet
-Bland, soft diet
-High calorie, high protein diet
-High calorie, high protein diet
Which nursing diagnosis is most appropriate for a client with COPD complaining of being "too tired from breathing to eat"
-Altered nutrition less than body requirements related to fatigue
-Weight loss related to dyspnea
-Activity intolerance related to dyspnea
-Ineffective breathing pattern related to alveolar hypoventilation
-Altered nutrition less than body requirements related to fatigue
A client with COPD is receiving supplemental oxygen at 3L/Min. Which of the following is correct about hypoxic drive?
-The client doesn't notice he needs to breath
-The client breaths only when his oxygen levels dip below a certain point
-The client breaths only when his oxygen levels dip below a certain point
Clients with chronic bronchitis are given diuretic therapy. Which of the following reason best explains why?
-Reducing fluid volume reduces oxygen demand
-Restricting fluid volume reduces sputum production
-Reducing fluid volume improves client's mobility
-Reduces fluid volume improves respiratory function
-Reducing fluid volume reduces oxygen demand
The RN is caring for a client hospitalized with exacerbation of COPD. Which of the following is expected upon assessment?
-Increased oxygen saturation with exercise
-A hyperinflated chest on x-ray film
-Hypocapnia
-A widened diaphragm noted on chest x-ray film
-A hyperinflated chest on x-ray film
The client asks the nurse to explain the purpose of pursed lip breathing. Which explanation should the nurse provide?
-It helps prevent early airway collapse
-It decreases use of accessory breathing muscles
-It increases inspiratory muscle strength
-It prolongs the inspiratory phase of respiration
-It helps prevent early airway collapse
You check on your patient with COPD the pulse ox reads 89% and they are resting comfortably. You next action is to?
-Continue to monitor the patient
-Notify the doctor for further orders
-Increase the patient O2 level to 3 L
-Turn off the alarm settings
-Continue to monitor the patient
A cyanotic client with an unknown diagnosis comes to the ER. IN relation to O2, the first nursing action would be to?
-Wait until the clients lab work is done
-Administer oxygen at 2 L per minute
-Not administer oxygen unless ordered by the physician
-Administer oxygen at 10L flow per minute and check the client's nail beds
-Administer oxygen at 2 L per minute
The Rn is teaching the patient about pursed lip breathing. What guidelines should the nurse include. Select all that apply
-Exhalation should be 3 times as long as inhalation
-Puff cheeks while doing pursed lip breathing
-Purse lips like whistling to exhale
-Use pursed lip breathing and after activities
-Exhalation should be 3 times as long as inhalation
-Purse lips like whistling to exhale
-Use pursed lip breathing and after activities
The nurse is assessing the patient diagnosed with COPD. Which data requires immediate intervention by the nurse
-Large amounts of white thick sputum
-Use of accessory muscles during inspiration
-O2 flowmeter set at 8L
-Presence of a barrel chest and dyspnea
-O2 flowmeter set at 8L
A nurse plans care for a client with COPD, knowing that the client is most likely to experience what type of imbalance?
-Respiratory acidosis
-Metabolic acidosis
-Respiratory alkalosis
-Metabolic alkalosis
-Respiratory acidosis
What should the nurse teach a patient with intermittent asthma about identifying specific triggers of asthma?
-Food and drug allergies do not cause respiratory symptoms
-Exercise-induced asthma is seen only in persons with sensitivity to cold air
-Asthma attacks are psychogenic in origin and can be controlled with relaxation techniques
-Viral upper reparatory infections are a common precipitating factor in acute asthma attacks
-Viral upper reparatory infections are a common precipitating factor in acute asthma attacks
A patient is admitted to the emergency department with an acute asthma attack. Which patient assessment is the greatest concern to the nurse?
-The presence of a pulses paradoxes
-Markedly decreased breath sounds with no wheezing
-A respiratory rate of 34 breaths/min and increased pulse and BP
-Use of accessory muscle of respiration and a feeling of suffocation
-Markedly decreased breath sounds with no wheezing
A patient with asthma has the following arterial blood gas (ABG) results early in an acute asthma attack: pH 7.48, partial pressure of carbon dioxide in arterial blood (PaCO2) 30 mm Hg, partial pressure of oxygen in arterial blood (PaO2) 78 mm Hg. What is the most appropriate action by the nurse?
-Prepare the patient for mechanical ventilation
-Have the patient breathe in a paper bag to raise the PcCO2
-Document the findings and monitor the ABGs for a trend toward acidosis
-Reduce the patient's oxygen flow rate to keep the PaO2 at the current level
-Document the findings and monitor the ABGs for a trend toward acidosis
What finding is an indication of marked bronchoconstriction with air trapping an hyperinflation of the lungs in a patient with asthma?
-Arterial oxygen saturation (SaO2) of 85%
-Peak (expiratory) flow meter (PEF) rate of < 200L/min
-Forced expiratory volume in 1 second (FEV1) of 85% of predicted
-Chest x-ray showing a flattened diaphragm
-Peak (expiratory) flow meter (PEF) rate of < 200L/min
Which medication should the nurse anticipate being used first in the emergency department for relief of severe respiratory distress related to asthma?
-Prednisone orally
-Tiotropium inhaler
-Fluticasone inhaler
-Albuterol nebulizer
-Albuterol nebulizer
When teaching the patient about going from a metered-dose inhaler (MDI) to a dry powder inhaler (DPI), which patient statement indicated to the nurse that the patient needs more teaching?
-I do not need to use the space like I used to
-I will hold my breath for 10 seconds or longer if I can
-I will not shake this inhaler like I did with m old inhaler
-I will store it is the bathroom, so I will be able to clean it when I need to
-I will store it is the bathroom, so I will be able to clean it when I need to
The nurse recognizes that additional teaching is necessary about medications when the patient with moderate asthma makes which statements (select all that apply)?
-If I can't afford all of my medications, I will only use the salmeterol
-I will stay inside if there is a high pollen count to prevent having an asthma attack
-I will rinse my mouth after using fluticason to prevent oral candidiasis
-I must have omalizumab injected every 2 to 4 weeks because inhalers don't help my asthma
-I can use my inhaler 3 times, every 20 minutes, before going to the hospital if my peak flow was not improved
-My gastroesophageal reflux disease medications will help my asthma, and my asthma medications will help my GERD
-My gastroesophageal reflux disease medications will help my asthma, and my asthma medications will help my GERD
To decrease the patient's sense of panic during an acute asthma attack, what is the best action for the nurse to do?
-Leave the patient alone to rest in a quiet, calm environment
-Stay with the patient and encourage slow, pursed-lip breathing
-Reassure the patient that the attack can be controlled with treatment
-Let the patient know that frequent monitoring is being done by measuring vital signs and arterial oxygen saturation by pulse oximetry
-Stay with the patient and encourage slow, pursed-lip breathing
When teaching the patient with mild asthma about the use of the peak flow meter, what should the nurse teach the patient to do?
-Always carry the flowmeter in case an asthma attack occurs
-Use the flowmeter to check the status of the patient's asthma every time the patient take quick-relief medications
-Follow the written asthma action plan if the expiratory flow rate is in the yellow zone
-Use the flowmeter by emptying the lungs, closing the mouth around the mouthpiece, and inhaling through the meter as quickly as possible
-Follow the written asthma action plan if the expiratory flow rate is in the yellow zone
The nurse recognizes that additional teaching is needed when the patient with asthma says
-I should exercise every day if my symptoms are controlled
-I may use one-the-counter bronchodilator drugs occasionally if I develop chest tightness
-I should inform my spouse about my medications and how to get help if I have a severe asthma attack
-A diary to record my medication use, symptoms, PEF rates, and activity levels will help in adjusting my therapy
-I may use one-the-counter bronchodilator drugs occasionally if I develop chest tightness
Tobacco smoke causes defects in multiple areas of the respiratory system. What is a long-term effect of smoking
-Bronchospasm and hoarseness
-Decreased mucus secretions and cough
-Increased function of alveolar macrophages
-Increased risk of infection and hyperplasia of mucous glands
-Increased risk of infection and hyperplasia of mucous glands
What causes the pulmonary vasoconstriction leading to the development of cor pulmonale in the patient with COPD?
-Increased viscosity of the blood
-Alveolar hypoxia and hypercapnia
-Long-term low-flow oxygen therapy
-Administration of high concentrations of oxygen
-Alveolar hypoxia and hypercapnia
In addition to smoking cessation, what treatment is included for COPD to slow the progression of the disease?
A. Use of bronchodilator drugs
B. Use of inhaled corticosteroids
C. Lung volume reduction surgery
D. Prevention of respiratory tract infections
D. Prevention of respiratory tract infections
Which method of low, constant oxygen administration is the safest system to use for a patient with COPD exacerbation?
-Venturi mask
-Nasal cannula
-Simple face mask
-Nonrebreather mask
-Venturi mask
What is characteristic of a partial rebreather mask?
-Use for long-term O2 therapy
-Reservoir bag conserves oxygen
-Provides highest oxygen concentrations
-Most comfortable and causes the least restriction on activities
-Reservoir bag conserves oxygen
Which breathing technique should the nurse teach the patient with moderate COPD to promote exhalation?
A. Huff coughing
B. Thoracic breathing
C. Pursed lip breathing
D. Diaphragmatic breathing
C. Pursed lip breathing
What does the nurse include when planning for postural drainage for the postural drainage for the patient with COPD?
-Schedules the procedure 1 hour before and after meals.
-Has the patient cough before positioning to clear the lungs
-Assess the patient's tolerance for dependent (head-down) positions
-Ensures that percussion and vibration are done before positioning the patient
-Assess the patient's tolerance for dependent (head-down) positions
Which dietary modification helps meet the nutritional needs of patients with COPD?
-Eating a high-carbohydrate, low fat diet
-Avoiding foods that require a lot of chewing
-Preparing most foods of the diet to be eaten hot
-Drinking fluids with meals to promote digestion
-Avoiding foods that require a lot of chewing
The nurse is caring for patient with COPD. Which intervention could be delegated to unlicensed assistive personnel (UAP)?
-Assist the patient to get out of bed
-Auscultate breath sounds every 4 hour
-Plan patient activities to minimize excretion
-Teach the patient pursed-lip breathing technique
-Assist the patient to get out of bed
During an acute exacerbation of mild COPD, the patient is severely short of breath. The nurse identifies a nursing diagnosis of impaired breathing, etiology: alveolar hypoventilation and anxiety. What is the best nursing action?
-Prepare and administer routine bronchodilator medications
-Perform chest physiotherapy to promote removal of secretions
-Administer oxygen at 5 L/min until the shortness of breath is relieved
-Position the patient upright with the elbows resting on the over-the bed table
-Position the patient upright with the elbows resting on the over-the bed table
The husband of a patient with severe COPD tells the nurse that he and his wife have not had any sexual activity since she was diagnosed with COPD because she becomes too short of breath. What is the nurse's best response
-You need to discuss your feelings and needs with your wife so that she know what you expect of her
-There are other ways to maintain intimacy besides sexual intercourse that will not make her shot of breath
-You should explore other ways to meet your sexual needs since your wife is no longer capable of sexual activity
-Would you like me to talk with you and your wife about some modifications that can be
-Would you like me to talk with you and your wife about some modifications that can be made to maintain sexual activity
What should the nurse include when teaching the patient with COPD about the need for physical exercise?
-All patients with COPD should be able to increase walking gradually up
-A bronchodilator inhaler should be used to relieve exercise-induced dyspnea immediately after exercise
-Shortness of breath is expected ruing exercise but should return to baseline within 5 minutes after the exercise
-Monitoring the heart rate before and after exercise is the best way to determine how much exercise can be tolerated
-Shortness of breath is expected ruing exercise but should return to baseline within 5 minutes after the exercise
Pulmonary rehabilitation (PR) is designed to reduce symptoms and improve the patient's quality of life. Along with improving exercise capacity, what are anticipated results of PR? (select all that apply)
-Decreased FEV1
-Decreased depression
-Increased oxygen need
-Decreased fear of exercise
-Decreased hospitalization
-Decreased depression
-Decreased fear of exercise
-Decreased hospitalization
What is the pathophysiologic mechanism of cystic fibrosis leading to obstruction lung disease?
-Fibrous of mucous glands and destruction of bronchial walls
-Destruction of lung parenchyma form inflammation and scarring
-Production of secretions low in sodium chloride and resulting thickened mucus
-Increased serum levels of pancreatic enzymes that are deposited in the bronchial mucosa
-Production of secretions low in sodium chloride and resulting thickened mucus
What is the primary principle involved in the various airway clearance device used for mobilizing secretions?
-Vibration
-Inhalation therapy
-Chest physiotherapy
-Positive expiratory pressure
-Positive expiratory pressure
A 92-year-old female patient is being admitted to the emergency department with severe shortness of breath. Being aware of the patient's condition, what approach should the nurse use to assess the patient's lungs (select all that apply)
-Apex to base
-Base to apex
-Lateral sequence
-Anterior then posterior
-Posterior then anterior
-Base to apex
-Posterior then anterior
What keeps alveoli from collapsing?
-Carina
-Surfactant
-Empyema
-Thoracic cage
-Surfactant
What accurately describes the alveolar sac?
-Line the lung pleura
-Warm and moisture inhaled air
-Terminal structures of the respiratory tract
-Contain dead air that is not available for gas exchange
-Terminal structures of the respiratory tract
Why does a patient's respiratory rate increase when there is an excess of carbon dioxide in the blood?
-CO2 displaces oxygen on hemoglobin, leading to a decrease PaO2
-CO2 causes an increase in the amount of hydrogen ions available in the body
-CO2 combines with water to form carbonic acid, which lowers the pH of cerebrospinal fluid
-CO2 directly stimulates chemoreceptors in the medulla to increase respiratory rate and volume
-CO2 combines with water to form carbonic acid, which lowers the pH of cerebrospinal fluid
What is a primary nursing responsibility after obtaining a blood specimen for ABGs?
-Add heparin to the blood specimen
-Apply pressure to the puncture site for 2 full minutes
-Take the specimen immediately to the laboratory in an iced container
-Avoid any change in oxygen intervention for 15 minutes following the procedure
-Take the specimen immediately to the laboratory in an iced container
A patient is concerned that he may have asthma. Of the symptoms that he describes to the nurse, which ones suggest asthma or risk factors for asthma? (select all that apply)
-Allergic rhinitis
-Prolonged inhalation
-Cough, especially at nigh
-Gastric reflux or heartburn
-History of chronic sinusitis
-Allergic rhinitis
-Cough, especially at nigh
-Gastric reflux or heartburn
-History of chronic sinusitis
Which findings indicate that a patient is developing asthmatics (select all that apply)?
-PEFR < 300 L/min
-Positive sputum culture
-Unable to speak in complete sentences
-Lack of response to conventional treatment
-Chest x-ray shows hyperinflated lungs and a flattened diaphragm
-PEFR < 300 L/min
-Unable to speak in complete sentences
-Lack of response to conventional treatment
Which statement indicates the patient with asthma requires further teaching about self-care?
-I use my corticosteroid inhaler when I feel short of breath
-I get a flue shot every year and see my HCP if I have an upper respiratory tract infection
-I use my inhaler before I visit my aunt who has a cat, but I only visit for a few minutes because of my allergies
-I walk 30 min every day but sometimes I have to use my bronchodilator inhaler before walking to prevent me from getting short of breath
-I use my corticosteroid inhaler when I feel short of breath
The plan of care for the patient with chronic obstructive pulmonary disease (COPD) should include (select all that apply)?
-exercise such as walking
-high flow rate of O2 administration
-low-dose chronic oral corticosteroid therapy
-use of peak flow meter to monitor the progression of COPD
-breathing exercises, such as pursed-lip breathing that focus on exhalation
-exercise such as walking
-breathing exercises, such as pursed-lip breathing that focus on exhalation
Which guideline should the nurse include when teaching a patient how to used a metered-dose inhaler (MDI)?
-After activating the MDI, breath in as quickly as you can
-Estimate the amount of remaining medicine in the MDI by floating the canister in water
-Disassemble the plastic canister from the inhaler and rinse both pieces under running water every week
-To determine how long the canister will last, divide the total number of puffs in the canister by the puffs needed per day
-To determine how long the canister will last, divide the total number of puffs in the canister by the puffs needed per day
A patient who has bronchiectasis asks the nurse, "What condition would warrant a call to the clinic?"
-Blood clots in the sputum
- Sticky sputum on a hot day
-Increased shortness of breath after eating a large meal
-Production of large amounts of sputum on a daily basis
-Blood clots in the sputum
A nurse is monitoring a group of clients for increased risk for developing pneumonia. Which of the following clients should the nurse expect to be at risk? (Select all that apply)
-Client who has dysphagia
-Client who has AIDS
-Client who was vaccinated for pneumococcus and influenza 6 months ago
-Client who is postoperative and has received local anesthesia
-Client who has a closed head injury and is receiving mechanical ventilation
-Client who has myasthenia gravis
-Client who has dysphagia
-Client who has AIDS
-Client who has a closed head injury and is receiving mechanical ventilation
-Client who has myasthenia gravis
A nurse is caring for a client who, upon awakening, was disoriented to person, place, and time. The client reports chills and chest pain that is worse upon inspiration. Which of the following actions is the nursing priority?
-Obtain baseline vital signs and oxygen saturation
-Obtain a sputum culture
-Obtain a complete history from the client
-Provide a pneumococcal vaccine
-Obtain baseline vital signs and oxygen saturation
A nurse is teaching a group of clients about influenza. Which of the following client statements indicates an understanding of the teaching?
-I should wash my hands after blowing my nose to prevent spreading the virus
-I need to avoid drinking fluids if I develop symptoms
-I need a flue shot every 2 years because of the different flu strains
-I should cover my mouth with my hand when I sneeze
-I should wash my hands after blowing my nose to prevent spreading the virus
A nurse in the emergency department is caring for a client who is experiencing an acute asthma attack. Which of the following assessments indicates that the respiratory status is declining? (select all that apply)
-SaO2 95%
-Wheezing
-Retraction of sternal muscles
-Pink mucous membranes
-Tachycardia
-Wheezing
-Retraction of sternal muscles
-Tachycardia
A nurse is caring for a client 2 hr after admission. The client has an SaO2 of 91%, exhibits audible wheezes, and is using accessory muscles when breathing. Which of the following classes of medications should the nurse expect to administer?
-Antibiotic
-Beta-blocker
-Antiviral
-Beta 2agonist
-Beta 2agonist
A nurse is providing discharge teaching to a client who has a new prescription of prednisone for asthma. Which of the following client statements indicates understanding?
-I will decrease my fluid intake while taking this medication
-I will expect to have black, tarry stools
-I will take my medication with meals
-I will monitor for weight loss while on this medication
-I will take my medication with meals
A nurse is assessing a client who has a history of asthma. Which of the following factors should the nurse identify as a risk for asthma?
-Sex
-Environmental allergies
-Alcohol use
-History of diabetes
-Environmental allergies
A nurse is reinforces teaching with a client on the purpose of taking a bronchodilator. Which of the following client statements indicates understanding?
-This medication can decrease my immune response
-I take this medication to prevent asthma attacks
-I need to take this medication with food
-This medication has a slow onset to treat my symptoms
-I take this medication to prevent asthma attacks
A nurse is providing discharge teaching to a client who has COPD and a new prescription for albuterol. Which of the following statements by the client indicates an understanding of the teaching?
-This medication can increase my blood sugar levels
-This medication can decrease my immune response
-I can have an increase in my heart rate while taking this medication
-I can have sores while taking this medication
-I can have an increase in my heart rate while taking this medication
A nurse is preparing to administer an initial dose of prednisone to a client who has COPD. The nurse should monitor for which of the following adverse effects of this medication? (Select all that apply)
-Hypokalemia
-Tachycardia
-Fluid retention
-Nausea
-Black, tarry stools
-Hypokalemia
-Fluid retention
-Black, tarry stools
A nurse is discharging a client who has COPD. The client is concerned about not being able to leave the house de to the need for staying on continuous oxygen. Which of the following responses should the nurse make?
-There are portable oxygen delivery systems that you can take with you
-When you go out, you can remove the oxygen and then reapply it when you get home
-You probably will not be able to go out as much as you used to
-Home health services will come to you so you will not need to get out
-There are portable oxygen delivery systems that you can take with you
A nurse is instructing a client on the use of an incentive spirometer. Which of the following statements by the client indicates an understanding of the teaching?
-I will place the adapter on my finger to read my blood oxygen saturation level
-I will lie on my back with my knees bent
-I will rest my hand over my abdomen to create resistance
-I will take in a deep breath and hold it before exhaling
-I will take in a deep breath and hold it before exhaling
A nurse is planning to instruct a client on how to perform pursed-lip breathing. Which of the following statements should the nurse include?
-Take quick breaths upon inhalation
-Place your hand over your stomach
-Take a deep breath in through your nose
-Puff your cheeks upon exhalation
-Take a deep breath in through your nose
The nurse teaches a patient with chronic bronchitis about a new prescription for Advair Diskus (combined fluticasone and salmeterol). Which action by the patient would indicate to the nurse that teaching about medication administration has been successful?
-The patient shake the device before use
-The patient rapidly inhales the medication
-The patient attaches a spacer to the Diskus
-The patient performs huff coughing after inhalation
-The patient rapidly inhales the medication
The home health nurse is visiting a patient with chronic obstructive pulmonary disease (COPD). Which nursing action is appropriate to implement for a nursing diagnosis of impaired breathing pattern related to anxiety?
-Titrate O2 to keep saturation at least 90%
-Teach the patient how to use pursed-lip breathing
-Discuss a high-protein, high -calorie diet with the patient
-Suggest the use of over-the-counter sedative medications
-Teach the patient how to use pursed-lip breathing
A patient with chronic obstructive pulmonary disease (COPD) has a nursing diagnosis of imbalanced nutrition: less than body requirements. Which intervention would be most appropriate for the nurse to include in the plan of care?
-Encourage increased intake of whole grains
-Increase the patient's intake of fruits and fruit juices
-Offer high-calorie protein snacks between meals and at bedtimes
-Assist the patient in choosing foods with high vegetable content
-Offer high-calorie protein snacks between meals and at bedtimes
The nurse interviews a patient with a new diagnosis of chronic obstructive pulmonary disease (COPD). Which information is most specific in confirming a diagnosis of chronic bronchitis?
-The patient tells the nurse about a family history of bronchitis
-The patient indicates a 30 pack-year cigarette smoking history
-The patient reports a productive cough for 3 months every winter
-The patient denies having respiratory problems until the past 12 months
-The patient reports a productive cough for 3 months every winter
Blood gas analysis reveals pH 7.32, PO2 58 mm Hg, PCO2 55 mm Hg, HCO3 21 mEq/L and oxygen saturation of 86%. The nurse recognizes these values as evidence of what?
-Normal acid-base balance
-Respiratory acidosis with hypoxemia
-Normal acid-base balance with hypercapnia
-Respiratory acidosis with normal oxygen levels
-Respiratory acidosis with hypoxemia
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