Question A 65-year-old patient, presents to the emergency department, with complaints of increasing dyspnea, productive cough with yellowish sputum, and wheezing. The patient has a history of smoking for 30 years. On physical examination, decreased breath sounds, and prolonged expiratory phase are noted. The arterial blood gas (ABG) results show pH 7.32, PaO2 55, PaCO2 65, and HCO3 28. Which intervention should the nurse prioritize for this patient?

A. Administer a short-acting bronchodilator.
B. Provide supplemental oxygen therapy.
C. Initiate intravenous corticosteroid therapy.
D. Obtain a sputum culture and sensitivity test.

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ANSWERS Below.

Question A 55-year-old patient with a long-standing diagnosis of COPD is admitted to the hospital with increased shortness of breath, cyanosis, and peripheral edema. The patient has a smoking history of 40 pack years and is currently on inhaled bronchodilators and corticosteroids. The nurse notes jugular vein distention (JVD) during physical assessment. Which intervention should the nurse implement for this patient?

A. Initiate continuous positive airway pressure (CPAP).
B. Administer intravenous (IV) diuretics.
C. Perform arterial blood gas (ABG) analysis.
D. Administer oxygen via a Venturi mask.

Question A 70-year-old patient with a history of COPD is seen in the outpatient clinic for a follow-up visit. The patient reports worsening dyspnea and an increased frequency of exacerbations. The patient’s current medications include inhaled bronchodilators and corticosteroids. What is the nurse’s priority action in managing this patient’s care?

A. Teach the patient about pursed-lip breathing technique.
B. Assess the patient’s inhaler technique and adherence.
C. Schedule pulmonary function tests (PFTs) for evaluation.
D. Discuss the benefits of pulmonary rehabilitation.

Question A 68-year-old patient with a history of COPD presents to the emergency department with increased dyspnea and chest tightness. The patient is using accessory muscles for breathing and has a respiratory rate of 28 breaths per minute. Oxygen saturation is 88% on room air. The nurse suspects acute exacerbation of COPD. Which intervention should the nurse implement first?

A. Administer a bronchodilator.
B. Administer intravenous (IV) corticosteroids.
C. Initiate noninvasive positive pressure ventilation (NPPV).
D. Obtain a chest X-ray.

Question A 60-year-old patient with a history of COPD is admitted to the medical-surgical unit for exacerbation. The patient is prescribed supplemental oxygen therapy. Which intervention is essential for the nurse to implement when administering oxygen to this patient?

A. Use a high-flow oxygen delivery system.
B. Keep the oxygen flow rate above 6 L/min.
C. Monitor the patient’s oxygen saturation continuously.
D. Encourage the patient to remove the oxygen mask during meals.

Question A 70-year-old patient with severe COPD is admitted to the intensive care unit (ICU) with acute respiratory failure. The patient requires mechanical ventilation. The healthcare provider orders volume-controlled mechanical ventilation with a low tidal volume strategy. What is the rationale for using a low tidal volume strategy in this patient?

A. To decrease the risk of barotrauma.
B. To improve oxygenation.
C. To reduce work of breathing.
D. To prevent atelectasis.

Question A 55-year-old patient with a history of smoking presents to the clinic with complaints of chronic cough, exertional dyspnea, and unintended weight loss. Physical examination reveals decreased breath sounds and hyperinflation of the chest. The nurse suspects emphysema. Which diagnostic test is most often used to confirm the diagnosis of emphysema?

A. Chest X-ray.
B. Pulmonary function tests (PFTs).
C. Arterial blood gas (ABG) analysis.
D. Computed tomography scan

Question A 40-year-old patient presents to the primary care clinic with a persistent cough and production of yellowish sputum for the past two weeks. The patient denies any history of smoking. Physical examination reveals normal breath sounds and no signs of respiratory distress. Based on the clinical presentation, which type of bronchitis is most likely in this patient?

A. Acute bronchitis.
B. Chronic bronchitis.
C. Allergic bronchitis.
D. Infectious bronchitis.

Question A 55-year-old patient with a history of smoking presents to the healthcare provider with a chronic cough and excessive mucus production for the past three months. The patient also reports dyspnea on exertion. Physical examination reveals increased anteroposterior diameter of the chest, wheezing, and prolonged expiration. Which type of bronchitis is most likely in this patient?

A. Acute bronchitis.
B. Chronic bronchitis.
C. Allergic bronchitis.
D. Infectious bronchitis.

Question A 62-year-old patient with emphysema is admitted to the hospital with worsening dyspnea. The nurse understands that which of the following is the primary underlying cause of dyspnea in patients with emphysema?

A. Airway obstruction.
B. Reduced lung compliance.
C. Increased pulmonary vascular resistance.
D. Alveolar hypoventilation.