Med Surg Elsevier Questions And
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During an assessment of a 45-yr-old patient with asthma, the nurse notes wheezing
and dyspnea. The nurse interprets that these symptoms are related to what
pathophysiologic change?
a. Laryngospasm
b. Pulmonary edema
c. Narrowing of the airway
d. Overdistention of the alveoli - ANSWER✔✔c. Narrowing of the airway
A 45-yr-old man with asthma is brought to the emergency department by
automobile. He is short of breath and appears frightened. During the initial nursing
assessment, which clinical manifestation might be present as an early manifestation
during an exacerbation of asthma?
a. Anxiety
b. Cyanosis
c. Bradycardia
d. Hypercapnia - ANSWER✔✔a. Anxiety
The nurse is assigned to care for a patient who has anxiety and an exacerbation of
asthma. What is the primary reason for the nurse to carefully inspect the chest wall
of this patient?
a.Allow time to calm the patient.
b.Observe for signs of diaphoresis.
c.Evaluate the use of intercostal muscles.
d.Monitor the patient for bilateral chest expansion. - ANSWER✔✔c.Evaluate the
use of intercostal muscles.
Which position is most appropriate for the nurse to place a patient experiencing an
asthma exacerbation?
a.Supine
b.Lithotomy
c.High Fowler's
d.Reverse Trendelenburg - ANSWER✔✔c.High Fowler's
,The nurse is caring for a patient with an acute exacerbation of asthma. After initial
treatment, what finding indicates to the nurse that the patient's respiratory status is
improving?
a.Wheezing becomes louder.
b.Cough remains nonproductive.
c.Vesicular breath sounds decrease.
d.Aerosol bronchodilators stimulate coughing. - ANSWER✔✔a.Wheezing
becomes louder.
The nurse identifies the nursing diagnosis of activity intolerance for a patient with
asthma. In patients with asthma, the nurse assesses for which etiologic factor for
this nursing diagnosis?
Work of breathing
Fear of suffocation
Effects of medications
Anxiety and restlessness - ANSWER✔✔Work of breathing
The nurse is assigned to care for a patient in the emergency department admitted
with an exacerbation of asthma. The patient has received a â-adrenergic
bronchodilator and supplemental oxygen. If the patient's condition does not
improve, the nurse should anticipate what as the most likely next step in treatment?
IV fluids
Biofeedback therapy
Systemic corticosteroids
Pulmonary function testing - ANSWER✔✔Systemic corticosteroids
A patient with an acute exacerbation of chronic obstructive pulmonary disease
(COPD) needs to receive precise amounts of oxygen. Which equipment should the
nurse prepare to use?
Oxygen tent
Venturi mask
Nasal cannula
Oxygen-conserving cannula - ANSWER✔✔Venturi mask
While teaching a patient with asthma about the appropriate use of a peak flow
meter, what should the nurse instruct the patient to do?
Keep a record of the peak flow meter numbers if symptoms of asthma are getting
worse.
, Use the flow meter each morning after taking medications to evaluate their
effectiveness.
Increase the doses of the long-term control medication if the peak flow numbers
decrease.
Empty the lungs and then inhale quickly through the mouthpiece to measure how
fast air can be inhaled. - ANSWER✔✔Keep a record of the peak flow meter
numbers if symptoms of asthma are getting worse.
The physician has prescribed salmeterol (Serevent) for a patient with asthma. In
reviewing the use of dry powder inhalers (DPIs) with the patient, what instructions
should the nurse provide?
"Close lips tightly around the mouthpiece and breathe in deeply and quickly."
"To administer a DPI, you must use a spacer that holds the medicine so that you
can inhale it."
"You will know you have correctly used the DPI when you taste or sense the
medicine going into your lungs."
"Hold the inhaler several inches in front of your mouth and breathe in slowly,
holding the medicine as long as possible." - ANSWER✔✔"Close lips tightly
around the mouthpiece and breathe in deeply and quickly."
The nurse determines that a patient is experiencing common adverse effects from
the inhaled corticosteroid beclomethasone after what occurs?
Hypertension and pulmonary edema
Oropharyngeal candidiasis and hoarseness
Elevation of blood glucose and calcium levels
Adrenocortical dysfunction and hyperglycemia - ANSWER✔✔Oropharyngeal
candidiasis and hoarseness
The nurse determines that the patient understood medication instructions about the
use of a spacer device when taking inhaled medications after hearing the patient
state what as the primary benefit?
"I will pay less for medication because it will last longer."
"More of the medication will get down into my lungs to help my breathing."
"Now I will not need to breathe in as deeply when taking the inhaler medications."
"This device will make it so much easier and faster to take my inhaled
medications." - ANSWER✔✔"More of the medication will get down into my
lungs to help my breathing."
Which test result identifies that a patient with asthma is responding to treatment?
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