CUPID2

A client with asthma has pronounced wheezing upon auscultation. Suspecting an impending asthma attack, a nurse should:

• have the client cough and deep breathe.

• prepare to intubate the client.

• prepare to administer a nebulized beta-2 adrenergic agonist.

• have the client lay on his or her right side

Answer explanation

In an impending asthma attack, administering a nebulized beta-2 adrenergic agonist is crucial as it helps relax bronchial muscles and relieve wheezing. Other options do not address the immediate need for bronchodilation.

A client, newly diagnosed with asthma is preparing for discharge. Which point should a nurse emphasize during the client's teaching?

• Contact care provider only if nighttime wheezing becomes a concern

• Limit exposure to sources that trigger an attack

• Use peak flow meter only if symptoms are worsening

• Use inhaled steroid medication as a rescue inhaler

Answer explanation

Limiting exposure to triggers is crucial for asthma management. It helps prevent attacks and promotes better control of the condition, making it the most important point for the client to understand during discharge.

A nurse is working with a client to update the client's asthma action plan. The nurse knows that this action plan should include information on:

• medication adjustments that should be made if peak flow is less than 50% normal.

• timeline for allergy skin testing.

• the most direct route when the client drives to the hospital.

• the best methods for chest physiotherapy (CPT).

Answer explanation

The asthma action plan must include medication adjustments for when peak flow is less than 50% normal, as this indicates a significant worsening of the condition requiring immediate intervention.

Which finding should a nurse expect when completing an assessment on a client with chronic bronchitis?

• Minimal sputum with cough

• Pink, frothy sputum

• Barrel chest

• Stridor on expiration

Answer explanation

In chronic bronchitis, a barrel chest is common due to air trapping and lung hyperinflation. Other options like minimal sputum or stridor are not typical findings in this condition.

A client learning about chronic obstructive pulmonary disease self-care at a community health class, asks a nurse why the participants are being taught about the 'lip-breathing.' The nurse should respond by explaining that pursed-lip breathing can help to:

• reduce upper airway inflammation.

• reduce anxiety through humor.

• strengthen respiratory muscles.

• increase effectiveness of inhaled medications.

Answer explanation

Pursed-lip breathing helps to strengthen respiratory muscles by promoting better airflow and reducing the work of breathing, which is particularly beneficial for clients with chronic obstructive pulmonary disease.

A home health nurse is visiting a client whose chronic bronchitis has recently worsened. Which instruction should the nurse reinforce with this client?

• Increase amount of bedrest

• Increase fluid intake

• Decrease caloric intake

• Reduce home oxygen use

Answer explanation

Increasing fluid intake helps thin mucus secretions, making it easier for clients with chronic bronchitis to breathe. This is crucial when their condition worsens, as hydration supports overall respiratory function.

A client with chronic obstructive pulmonary disease (COPD) is in the third postoperative day following right-sided thoracotomy. During the day shift, the client has required 10 L oxygen by mask to keep his or her oxygen saturations greater than 88%. Based on this information, which action should be taken by the evening shift nurse?

• Work to wean oxygen down to 3 L by mask

• Call respiratory therapy for a nebulizer treatment

• Check respiratory rate and notify the physician

• Administer dose of ordered pain medications

Answer explanation

The client requires high oxygen levels post-thoracotomy, indicating potential respiratory distress. Checking the respiratory rate and notifying the physician is crucial for assessing the situation and determining further interventions.

A client with a suspected pulmonary embolus receives a ventilation and quantification nuclear medicine (VQ) scan to evaluate regional lung ventilation of airflow and regional lung blood flow. In consulting with a physician, a nurse learns that there is a VQ mismatch. Based on this information, which action should be taken by the nurse?

• Tell the client that tuberculosis treatment will be needed

• Reassure the client that he/she does not have a pulmonary embolus

• Explain to the client that further testing will be needed

• Inform the client that the test was normal

Answer explanation

A VQ mismatch indicates abnormal blood flow in the lungs, often associated with pulmonary embolism. Therefore, the nurse should explain that further testing is necessary to confirm the diagnosis and guide treatment.

A nurse is helping a client with obstructive sleep apnea to apply a continuous positive airway pressure (CPAP) mask before going to sleep. The nurse knows that CPAP is intended to:

• breathe for the client during sleep.

• reduce intrathoracic pressure.

• deliver high concentrations of oxygen.

• prevent alveolar collapse.

Answer explanation

CPAP is designed to prevent alveolar collapse by maintaining positive airway pressure, ensuring that the airways remain open during sleep, which is crucial for clients with obstructive sleep apnea.

A nurse begins to hear high-pressure alarms in the room of a client requiring respiratory assistance with a ventilator. Which is the best action by the nurse?

• Wait and allow the client time to regulate breathing in coordination with the ventilator

• Check ventilator tubing and connections

• Silence the alarm and restart the ventilator

• Lower the tidal volumes being delivered to the client

Answer explanation

The best action is to check ventilator tubing and connections, as high-pressure alarms often indicate a blockage or disconnection. This ensures the ventilator functions properly and the client receives adequate respiratory support.