A patient who has a diagnosis of chronic bronchitis is experiencing an acute exacerbation. Assessments include increasing dyspnea and a cough producing thick, purulent mucus. Which class of medications should the healthc
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A patient who has a diagnosis of chronic bronchitis is experiencing an acute exacerbation. Assessments include increasing dyspnea and a cough producing thick, purulent mucus. Which class of medications should the healthcare provider to administer first?
A
Leukotriene inhibitor
B
Beta-2 agonist
C
Non-steroidal anti-inflammatory agent
D
Mucolytic Correct Ans:- B Beta-2 agonist
For a patient who is in the late stages of chronic bronchitis, which of the following would indicate the patient has developed cor pulmonale?
A
Night sweats
B
Hepatomegaly
C
Hypocapnia
D
Venous stasis ulcers Correct Ans:- B Hepatomegaly
The healthcare provider is assessing a patient with a diagnosis of chronic bronchitis. Which of these physical findings represents the effects of air trapping in this patient?
A
The sternum is prominently protruding from the chest.
B
There are indentations in the intercostal spaces during inspiration.
C
Asymmetrical expansion of the thorax is noted during inspiration.
D
The width of the chest is equal to the depth of the chest. Correct Ans:- D The width of the chest is equal to the depth of the chest.
A patient who has a diagnosis of chronic bronchitis is experiencing an acute exacerbation and is progressing to respiratory failure. When assessing the patient, which of these will be expected?
A
Bradycardia
B
Altered level of consciousness
C
Weak, thready pulse
D
Hypotension Correct Ans:- B Altered level of consciousness
The healthcare provider is assessing a patient with a 20 year history of smoking and a chronic cough. Which description of the patient's cough best supports a diagnosis of chronic bronchitis?
A
"Usually my cough occurs in the evening."
B
"My cough is brassy and hoarse."
C
"I sound like a barking seal when I cough."
D
"I cough up a lot of thick mucus." Correct Ans:- D "I cough up a lot of thick mucus."
A patient who has a diagnosis of chronic bronchitis is receiving albuterol (Proventil) via nebulizer to treat an acute exacerbation. Which assessment noted by the healthcare provider is an indication the patient is experiencing an side effect of this medication?
A
Urinary incontinence
B
Sedation
C
Tachycardia
D
Hypoglycemia Correct Ans:- C Tachycardia
A patient who has a history of chronic bronchitis is admitted to the medical unit. The healthcare provider notes the red blood cell count is elevated. Which of these is the likely contributing factor to this lab result in this patient?
A
Hypercapnia
B
Chronic hypoxia
C
Insensible water loss
D
Decreased fluid intake Correct Ans:- B Chronic hypoxia
A patient who has chronic bronchitis will be receiving oxygen therapy at home. The teaching plan for this patient should include which of these instructions?
Select all that apply:
A
"Be careful around open flames because liquefied oxygen is highly flammable."
B
"Do not allow smoking in your home while you are receiving oxygen therapy."
C
"Your body may forget to breathe if you turn the oxygen up too high."
D
"Oxygen can be addictive so it should be used only when needed."
E
"Be sure to wash the nasal cannula prongs twice each week to decrease infection risk." Correct Ans:- B,C,E
The healthcare provider is teaching a patient strategies to manage chronic bronchitis. Which of these will be included in the teaching?
Select all that apply:
A
"You should decrease fluid intake to control the amount of edema."
B
"Here's the address of a nearby smoking cessation support group."
C
"It's important for you to avoid being around people who are sick."
D
"Limiting your physical activity is very important."
E
"I'll show you how to use a spacer when you take your medication." Correct Ans:- B,C,E
The healthcare provider is caring for a patient experiencing an acute exacerbation of chronic bronchitis. The patient is coughing uncontrollably and is using accessory muscles to breathe. Which of these interventions will support the patient's respiratory status?
Select all that apply:
A
Administer cough suppressant
B
Administer a corticosteroid
C
Provide humidified oxygen via face mask
D
Assist the patient to a side-lying position.
E
Administer a short acting beta-2 agonist Correct Ans:- B,C,E
The healthcare provider is assisting a patient with severe anemia with ambulation. The patient suddenly experiences dyspnea. What should the healthcare provider do first?
A
Ask a colleague to get a wheelchair for the patient.
B
Administer oxygen to the patient.
C
Quickly assist the patient back to their bed.
D
Ease the patient to the floor to prevent injury. Correct Ans:- A Ask a colleague to get a wheelchair for the patient.
During a routine prenatal visit by a woman at 24weeks' gestation, the healthcare provider notes the woman's pre-pregnancy hematocrit was 42%, but today the hematocrit is 34%. Which of the following provides the best explanation of the change in hematocrit for this patient?
:
A
The woman is anemic because more of her blood is being diverted to the placenta and fetus.
B
During pregnancy the increase in plasma volume exceeds the increase in erythrocyte production.
C
Because she has been experiencing pregnancy-related nausea, the woman's diet has been poor.
D
Because of pregnancy-related immune suppression, the woman is not making enough erythrocytes. Correct Ans:- B During pregnancy the increase in plasma volume exceeds the increase in erythrocyte production.
The healthcare provider is reviewing a patient's laboratory results and notes the hemoglobin is 9 and the hematocrit is 28%. Which of the following orders will the healthcare provider expect to implement first?
A
Administer PO ferrous sulfate (iron).
B
Administer cyanocobalamin (vitamin B12) IM.
C
Draw blood for red blood cell indices.
D
Type and cross for a blood transfusion. Correct Ans:- C Draw blood for red blood cell indices.
During the assessment of a patient suspected of anemia secondary to a nutritional deficiency, which question is important for the healthcare provider to ask the patient?
A
"Have you noticed if your stools have changed color?"
B
"Do you ever experience numbness or tingling of your extremities?"
C
"Have you noticed if your gums bleed when you brush your teeth?"
D
"What over-the counter medications do you take regularly?" Correct Ans:- B "Do you ever experience numbness or tingling of your extremities?"
A 58 year old client with a 40 year hx of smoking one to two packs of cigarettes a day has chronic cough producing thick sputum, peripheral edema, and cyanotic nail beds. Based on this info, he most likely has which of the following conditions?
A
Adult respiratory distress syndrome (ARDS)
B
Asthma
C
Chronic obstructive bronchitis
D
Emphysema Correct Ans:- C Chronic obstructive bronchitis
The LPN is preparing to perform oral care for an unconscious pt. Which of the following actions should the LPN do first?
A
Perform a swallowing test
B
Place the pt in the Sims position
C
Separate the teeth with a padded tongue blade
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