Chapter 29 Nursing Management Obstructive Pulmonary...

Chapter 29: Nursing Management: Obstructive Pulmonary Diseases Test Bank MULTIPLE CHOICE 1. 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? a. The patient shakes the device before use. b. The patient attaches a spacer to the Diskus. c. The patient rapidly inhales the medication. d. The patient performs huff coughing after inhalation. ANS: C The patient should inhale the medication rapidly. Otherwise the dry particles will stick to the tongue and oral mucosa and not get inhaled into the lungs. Advair Diskus is a dry powder inhaler;†¦show more content†¦a. No wheezes are audible. b. Oxygen saturation is 90%. c. Accessory muscle use has decreased. d. Respiratory rate is 16 breaths/minute. ANS: B The goal for treatment of an asthma attack is to keep the oxygen saturation 90%. The other patient data may occur when the patient is too fatigued to continue with the increased work of breathing required in an asthma attack. DIF: Cognitive Level: Apply (application) REF: 569 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity 6. A patient seen in the asthma clinic has recorded daily peak flows that are 75% of the baseline. Which action will the nurse plan to take next? a. Increase the dose of the leukotriene inhibitor. b. Teach the patient about the use of oral corticosteroids. c. Administer a bronchodilator and recheck the peak flow. d. Instruct the patient to keep the next scheduled follow-up appointment. ANS: C USTESTBANK.COM The patient’s peak flow reading indicates that the condition is worsening (yellow zone). The patient should take the bronchodilator and recheck the peak flow. Depending on whether the patient returns to the green zone, indicating well-controlled symptoms, the patient may be prescribed oral corticosteroids or a change in dosing of other medications. Keeping the next appointment is appropriate, but the patient also needs to be taught how to control symptoms now and use the bronchodilator. 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