Question 1: A 55-year-old client diagnosed with chronic bronchitis is being educated on self-care measures. Which statement by the client indicates a need for further teaching? A. “I’ll make sure to get flu shots annually.”
B. “It’s okay for me to smoke as long as it’s not more than a pack a week.”
C. “I should avoid being around people who are sick.”
D. “Using a humidifier at night might help me breathe easier.
E. “Exercising regularly can help improve my lung function.”
Rationale: Smoking is a leading cause of chronic bronchitis and can exacerbate the condition, regardless of the quantity smoked. Stopping smoking is crucial for clients with chronic bronchitis to prevent further lung damage and improve symptoms. The other options reflect appropriate self-care measures for managing chronic bronchitis, including vaccinations, avoiding sick contacts, using humidifiers to ease breathing, and exercising to improve lung function.
Question 2: A nurse is caring for a client with acute bronchitis. Which assessment finding would most likely be present?
A. Wheezing
B. Clubbing of fingers
C. Barrel chest
D. Cyanosis
E. Dry skin
Rationale: Acute bronchitis often presents with wheezing due to inflammation of the airways. Clubbing of fingers, barrel chest, and cyanosis are more commonly associated with chronic respiratory conditions, not acute bronchitis. Dry skin is a non-specific symptom that can be seen in many conditions but is not directly associated with acute bronchitis.
Question 3: A client with chronic bronchitis reports increased difficulty breathing. The nurse recognizes which of the following as the most likely cause?
A. Decreased cardiac output
B. Airway obstruction from mucus buildup
C. Reduced blood oxygen levels
D. Infection with a new pathogen
E. An allergic reaction
Rationale: Chronic bronchitis is characterized by the production of large amounts of mucus due to inflammation of the airways, leading to obstruction and difficulty breathing. While reduced blood oxygen levels and infections can exacerbate symptoms, they are consequences rather than causes of the increased difficulty breathing. Decreased cardiac output and allergic reactions are less directly related to the respiratory symptoms seen in chronic bronchitis.
Question 4: During discharge teaching for a client recovering from bronchitis, which instruction should the nurse prioritize?
A. Limit physical activity for at least a month.
B. Drink at least eight glasses of water daily.
C. Avoid over-the-counter cough suppressants.
D. Use oxygen therapy continuously.
E. Increase protein intake significantly.
Rationale: Hydration is crucial in the management of bronchitis as it helps to thin mucus, making it easier to expectorate and thereby reducing airway obstruction. While limiting strenuous physical activity may be advised in the acute phase, a month-long limitation is excessive. Over-the-counter cough suppressants can sometimes be used, but this advice should be individualized. Continuous oxygen therapy is typically not necessary for clients recovering from bronchitis unless specified by a healthcare provider, and while nutrition is important, there’s no need to significantly increase protein intake specifically for bronchitis recovery.
Question 5: A client diagnosed with acute bronchitis asks the nurse what they can do to feel better. Which of the following is the best recommendation?
A. “Take antibiotics as prescribed.”
B. “Rest and drink plenty of fluids.”
C. “Start using an inhaler immediately.”
D. “Restrict fluids to decrease mucus production.”
E. “Increase your caffeine intake to improve alertness.”
Rationale: For most cases of acute bronchitis, which is typically viral, rest and adequate hydration are key components of care. Antibiotics are not usually recommended because most cases of acute bronchitis are caused by viruses. Using an inhaler might be appropriate for some clients, particularly those with underlying asthma or COPD, but it is not a general recommendation. Restricting fluids and increasing caffeine intake are not advisable as they can contribute to dehydration and worsen symptoms.
Question 6: A nurse is educating a community group on preventing respiratory infections like bronchitis. Which point should be emphasized?
A. Avoiding outdoor exercise
B. Getting annual vaccinations
C. Using antibiotic prophylaxis regularly
D. Wearing masks at all times indoors
E. Increasing intake of vitamin C supplements
Rationale: Annual vaccinations, particularly against influenza and pneumococcal infections, are critical in preventing respiratory infections that can lead to or exacerbate bronchitis. Avoiding outdoor exercise is not necessary for preventing bronchitis and can actually reduce overall health. Antibiotic prophylaxis is not recommended for preventing bronchitis due to the risk of antibiotic resistance and because many cases of bronchitis are viral. While wearing masks can reduce the spread of respiratory infections, emphasizing it as the primary preventive measure over vaccinations is less effective. Increasing vitamin C intake has not been proven to prevent respiratory infections to the extent that vaccines have.
Question 7: The nurse is assessing a client with chronic bronchitis. Which symptom is the client most likely to report?
A. Sharp chest pain with deep breaths
B. Intermittent episodes of vertigo
C. Persistent, productive cough for 3 months
D. Sudden onset of high fever
E. Rapid weight gain
Rationale: A hallmark symptom of chronic bronchitis is a persistent, productive cough that lasts for at least three months and occurs for two consecutive years. Sharp chest pain with deep breaths is more indicative of pleuritic chest pain or pneumothorax. Intermittent episodes of vertigo are not specifically related to chronic bronchitis. Sudden onset of high fever suggests an acute infection rather than a chronic condition. Rapid weight gain is not a typical symptom of chronic bronchitis and might indicate heart failure or other conditions.
Question 8: A client with a history of chronic bronchitis is experiencing a severe exacerbation. Which of the following interventions should the nurse prepare to implement first?
A. Administering a short-acting bronchodilator
B. Starting intravenous corticosteroids
C. Providing supplemental oxygen
D. Recommending increased fluid intake
E. Scheduling a chest X-ray
Rationale: In the case of a severe exacerbation of chronic bronchitis, the first priority is to open the airways and improve breathing, which can be achieved with a short-acting bronchodilator. Corticosteroids may be used to reduce inflammation but are not the first-line intervention for acute breathing difficulty. Supplemental oxygen may be necessary, but only after assessing the client’s oxygen saturation and ensuring the airways are open. Increased fluid intake and a chest X-ray are supportive measures but are not the immediate priority in a severe exacerbation.
Question 9: A nurse is providing teaching for a client recently diagnosed with chronic bronchitis. Which lifestyle modification should be emphasized to slow the progression of the disease?
A. Adopting a high-carbohydrate diet
B. Engaging in high-intensity exercise routines
C. Avoiding exposure to air pollutants
D. Limiting fluid intake to prevent fluid overload
E. Taking daily aspirin to reduce inflammation
Rationale: For clients with chronic bronchitis, it is critical to avoid irritants that can exacerbate the condition, including air pollutants like smoke, dust, and chemical fumes. This can help slow disease progression and reduce symptom frequency and severity. A high-carbohydrate diet is not specifically recommended, and exercise routines should be tailored to the individual’s tolerance level. Limiting fluid intake is not advisable as adequate hydration helps thin mucus. Daily aspirin is not a standard treatment for chronic bronchitis and should only be taken if prescribed by a healthcare provider for other conditions.
Question 10: A nurse is assessing a client with bronchitis for signs of respiratory distress. Which of the following findings would indicate a worsening condition?
A. Decreased respiratory rate
B. Slight increase in sputum production
C. Use of accessory muscles to breathe
D. Occasional cough
E. Mild fatigue
Rationale: The use of accessory muscles to breathe is a sign of increased work of breathing and can indicate respiratory distress or worsening of a respiratory condition such as bronchitis. This finding warrants immediate assessment and possibly escalated care. A decreased respiratory rate could indicate respiratory depression or fatigue but is less specific to worsening bronchitis. While an increase in sputum production and cough are symptoms of bronchitis, they do not specifically indicate acute respiratory distress. Mild fatigue is a common symptom but does not directly suggest a worsening respiratory status.