1. A client with chronic obstructive pulmonary disease (COPD) presents with shortness of breath. What is the nurse's priority action?
• A. Administer a bronchodilator
• B. Position the client supine
• C. Apply 6 L/min oxygen via nasal cannula
• D. Encourage deep breathing exercises
Ans...
1. A client with chronic obstructive pulmonary disease (COPD) presents with
shortness of breath. What is the nurse's priority action?
• A. Administer a bronchodilator
• B. Position the client supine
• C. Apply 6 L/min oxygen via nasal cannula
• D. Encourage deep breathing exercises
Answer: A. Administer a bronchodilator
Rationale: The priority for COPD exacerbations is to improve airway patency, which is
achieved through bronchodilation. Supplemental oxygen should be used with caution in COPD
patients to avoid CO2 retention.
2. A nurse is teaching a client about using a metered-dose inhaler (MDI) for
asthma. Which of the following indicates correct use of the MDI?
• A. The client breathes in quickly during administration
• B. The client holds their breath for 5 to 10 seconds after inhaling
• C. The client shakes the inhaler only after use
• D. The client administers two puffs without waiting between doses
Answer: B. The client holds their breath for 5 to 10 seconds after inhaling
Rationale: Holding the breath allows the medication to be absorbed into the lungs more
effectively. Shaking the inhaler before use and waiting between puffs are also important.
3. Which assessment finding is most concerning in a client with pneumonia?
• A. Fever of 101°F
• B. Productive cough with green sputum
• C. Respiratory rate of 28 breaths per minute
• D. SpO2 of 88% on room air
Answer: D. SpO2 of 88% on room air
Rationale: Oxygen saturation below 90% indicates significant hypoxemia, which requires
immediate intervention to prevent further respiratory compromise.
4. Which nursing intervention is most effective in preventing atelectasis in a post-
operative client?
, • A. Administering antibiotics
• B. Encouraging incentive spirometry use
• C. Limiting fluid intake
• D. Providing supplemental oxygen
Answer: B. Encouraging incentive spirometry use
Rationale: Incentive spirometry promotes deep breathing and lung expansion, preventing
atelectasis by reducing airway collapse.
5. A nurse is caring for a client with pulmonary embolism. Which of the
following clinical manifestations should the nurse expect?
• A. Bradycardia and peripheral edema
• B. Sudden chest pain and dyspnea
• C. Fever and productive cough
• D. Barrel-shaped chest and hyperresonance to percussion
Answer: B. Sudden chest pain and dyspnea
Rationale: Pulmonary embolism typically presents with acute onset of chest pain, dyspnea, and
hypoxia.
6. Which client statement indicates understanding of discharge instructions
following a bronchoscopy?
• A. "I will not eat or drink until my gag reflex returns."
• B. "I can resume all my usual activities immediately."
• C. "I can have fluids as soon as I get home."
• D. "I will take a hot shower to relax my airway."
Answer: A. "I will not eat or drink until my gag reflex returns."
Rationale: To prevent aspiration, the client must wait for the gag reflex to return before eating
or drinking following a bronchoscopy.
7. The nurse is educating a client with asthma about peak flow meter use. Which
action is correct?
• A. Blow out slowly and steadily into the meter
• B. Measure peak flow at bedtime
• C. Record the highest of three readings
• D. Use the meter after taking a short-acting bronchodilator
, Answer: C. Record the highest of three readings
Rationale: The client should blow out forcefully into the meter and record the highest value
obtained after three attempts, ensuring an accurate measurement of peak expiratory flow.
8. A client with tuberculosis (TB) is prescribed isoniazid. Which lab value should
the nurse monitor closely?
• A. Creatinine
• B. ALT and AST
• C. Hemoglobin
• D. Platelet count
Answer: B. ALT and AST
Rationale: Isoniazid can cause hepatotoxicity, so monitoring liver enzymes (ALT, AST) is
essential.
9. A client with cystic fibrosis is admitted with increased dyspnea and cough.
What is the nurse’s priority intervention?
• A. Start intravenous antibiotics
• B. Administer chest physiotherapy
• C. Restrict fluids
• D. Provide a low-sodium diet
Answer: B. Administer chest physiotherapy
Rationale: Chest physiotherapy helps to mobilize and clear thick mucus from the lungs,
improving ventilation and oxygenation.
10. A nurse is caring for a client with status asthmaticus. Which of the following
interventions should the nurse implement first?
• A. Obtain a chest x-ray
• B. Administer an albuterol nebulizer treatment
• C. Administer oral prednisone
• D. Initiate IV fluids
Answer: B. Administer an albuterol nebulizer treatment
Rationale: Albuterol, a rapid-acting bronchodilator, is the first-line treatment for relieving
bronchospasm in status asthmaticus.
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