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MSN Exam for Asthma (PM)*
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Question 1
How can seasonal asthma come about?
A
Inhalation or exposure to trees, grasses or flowers releasing pollen into the air.
B
Inhalation of tobacco smoke
C
Exposure to paint thinners or dust
Question 2
A slightly obese female client with a history of allergy-induced asthma, hypertension, and mitral valve prolapse is admitted to an acute care facility for elective surgery. The nurse obtains a complete history and performs a thorough physical examination, paying special attention to the cardiovascular and respiratory systems. When percussing the client’s chest wall, the nurse expects to elicit:
A
Resonant sounds.
B
Hyperresonant sounds.
C
Dull sounds.
D
Flat sounds.
Question 2 Explanation:
When percussing the chest wall, the nurse expects to elicit resonant sounds — low-pitched, hollow sounds heard over normal lung tissue. Hyperresonant sounds indicate increased air in the lungs or pleural space; they’re louder and lower pitched than resonant sounds. Although hyperresonant sounds occur in such disorders as emphysema and pneumothorax, they may be normal in children and very thin adults. Dull sounds, normally heard only over the liver and heart, may occur over dense lung tissue, such as from consolidation or a tumor. Dull sounds are thudlike and of medium pitch. Flat sounds, soft and high-pitched, are heard over airless tissue and can be replicated by percussing the thigh or a bony structure.
Question 3
Asthma is caused by inflammation of the airways in the lungs.
A
True
B
False
Question 4
A client with asthma has low pitched wheezes present on the final half of exhalation. One hour later the client has high pitched wheezes extending throughout exhalation. This change in assessment indicates to the nurse that the client
A
Has increased airway obstruction
B
Has improved airway obstruction
C
Needs to be suctioned
D
Exhibits hyperventilation
Question 4 Explanation:
The higher pitched a sound is, the more narrow the airway. Therefore, the obstruction has increased or worsened. With no evidence of secretions no support exists to indicate the need for suctioning.
Question 5
Staff who smoke on their personal time cannot harm children with Asthma.
A
True
B
False
Question 5 Explanation:
Secondhand smoke can be present on your clothing therefore exposing children to it. Never smoke in clothing you wear to work.
Question 6
The parameter to detect reversibility in airflow obstruction on a spirometry test is:
A
FEV1
B
FVC
C
MVV
D
RV
Question 7
Which of the following respiratory condition is always considered a medical emergency?
A
Laryngeotracheobronchitis (LTB)
B
Epiglottitis
C
Asthma
D
Cystic Fibrosis
Question 7 Explanation:
Acute and sever inflammation of the epiglottis can cause life threatening airway obstruction, that is why its always treated as a medical emergency. NSG intervention : Prepare tracheostomy set at bed side.
LTB, can also cause airway obstruction but its not an emergency. Asthma is also not an emergency (ung status asthmaticus ang kaylangan ng prompt treatment). CF is a chronic disease, so its not a medical emergency.
Question 8
Which of the following tests cannot detect airway inflammation?
A
Bronchial mucosal biopsy
B
Sputum eosinophil counts
C
Bronchoalveolar lavage
D
Spirometry
Question 9
Which statement is true about Asthma:
A
Asthma is one of the most common chronic diseases nationwide, impacting the lives and families of over 7 million children.
B
Asthma is the third-ranking cause of hospitalization among children under 15.
C
An average of one our of every 10 school-aged children has asthma and 10.5 million school days are missed each year due to Asthmas
D
All of the above is true
Question 10
An 8-year-old boy with asthma is brought to the clinic for check up. The mother asks the nurse if the treatment given to her son is effective. What would be the appropriate response of the nurse?
A
I will review first the child’s height on a growth chart to know if the treatment is working
B
I will review first the child’s weight on a growth chart to know if the treatment is working
C
I will review first the number of prescriptions refills the child has required over the last 6 months to give you an accurate answer
D
I will review first the number of times the child has seen the pediatrician during the last 6 months to give you an accurate answer
Question 10 Explanation:
Reviewing the number of prescription refills the child has required over the last 6 months would be the best indicator of how well controlled and thus how effective the child’s asthma treatment is. Breakthrough wheezing, shortness of breath, and upper respiratory infections would require that the child take additional medication. This would be reflected in the number of prescription refills.
Question 11
The following bronchodilator is most commonly used when doing a reversibility test:
A
Salbutamol
B
Adrenaline
C
Theophylline anhydrous
D
Atropine
Question 12
The characteristic feature of persistent asthma is:
A
Family history of disease
B
Airway inflammation
C
Need for oral steroids
D
Nocturnal wheezing
Question 13
A 19-year-old patient comes to the ED with acute asthma. His respiratory rate is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions should you take first?
A
Take a full medical history.
B
Give a bronchodilator by nebulizer.
C
Apply a cardiac monitor to the patient.
D
Provide emotional support for the patient
Question 13 Explanation:
The patient having an acute asthma attack needs more oxygen delivered to his lungs and body. Nebulized bronchodilators open airways and increase the amount of oxygen delivered. The patient may not need cardiac monitoring because he’s only 19 years old, unless he has a medical history of cardiac problems.
Question 14
Asthma causes the airways to:
A
Constrict
B
Become imflammed
C
Become lined with a large amount of mucus
D
All of the above
Question 15
True/False: Gastroesophageal reflux should be considered in a patient who has poorly controlled asthma, with a significant nocturnal component.
A
True
B
False
Question 15 Explanation:
A significant correlation between nocturnal asthma and gastroesophageal reflux has been observed. The patient may not complain of epigastric burning or have reflux symptoms. Cough may be the only symptom.
Question 16
Evidence suggests there are 3 crucial factors in the primary prevention of asthma. These include ..
A
Avoidance of household pets, obesity and allergen avoidance
B
Exposure to environmental tobacco smoke, breast feeding during infancy and allergen avoidance
C
Drug therapy with associated disease, avoidance of sedentary behaviour and exposure to environmental tobacco smoke
D
Breastfeeding during infancy, residing at least 20 km outside a major city and gaining at least 3 hours of oxygen from outdoors per day
Question 17
The following are helpful in determining the severity of an acute attack except:
A
Use of accersoy muscles of respiration
B
Ability to complete sentences
C
Peak expiratory flow rate
D
Pedal edema
Question 18
Which finding would alert a nurse that a hospitalized 6-year-old child is at risk for a severe asthma exacerbation?
A
Oxygen saturation of 95%
B
Mild work of breathing
C
Absence of intercostals or substernal retractions
D
History of steroid-dependent asthma
Question 18 Explanation:
A history of steroid-dependent asthma, a contributing factor to this client’s high-risk status, requires the nurse to treat the situation as a severe exacerbation regardless of the severity of the current episode. An oxygen saturation of 95%, mild work of breathing, and absence of intercostals or substernal retractions are all normal findings.
Question 19
The key role of a physiotherapist in treatment of asthma is to ...
A
Provide education to the patient about the disease and treatment options
B
Administering and educating the patient about airway clearance techniques
C
Provide education about exercise and the option of pulmonary rehabilitation classes
D
All of the above
E
None of the above
Question 20
A 5 year old AA male comes in with a history of asthma, but currently is not on any medication. In the history, you find out he uses his Albuterol MDI with spacer once every two weeks during the day. He does wake up 2-3 times per week coughing at night. How would you classify his asthma?
A
Intermittent
B
Mild Persistent
C
Moderate Persistent
D
Severe Persistent
Question 20 Explanation:
Moderate persistent, great than one night per week of symptoms bumps him to Moderate persistent
Question 21
True/False: If a patient has had coughing or wheezing for over one year, the possiblity of a foreign body is essentially ruled out.
A
True
B
False
Question 21 Explanation:
The acute cough and/or wheeze caused by a foreign body in the lower respiratory tract may diminish over time only to recur later and present as chronic cough and/or persistent wheezing.
Question 22
If a person suffers from asthma, what are the likely symptoms he/she may have?
A
Sore, swollen and sensitive airway linings.
B
Weak breathing
C
Fast and unsteady pulse
D
Cancer in the airway
Question 23
In those with asthma, which of the following does not contribute to inspiratory muscle weakness ?
A
Increased use of steroid based medication
B
Dyspnea
C
Reduced exercise tolerance
D
Inflammatory processes
Question 24
Which of the following is true?
A
A preventer is used to relieve asthma attacks.
B
A reliever is used to relieve asthma attacks.
Question 25
Carol Smith is using bronchodilators for asthma. The side effects of these drugs that you need to monitor this patient for include:
A
tachycardia, nausea, vomiting, heart palpitations, inability to sleep, restlessness, and seizures.
B
tachycardia, headache, dyspnea, temp . 101 F, and wheezing.
C
blurred vision, tachycardia, hypertension, headache, insomnia, and oliguria.
D
restlessness, insomnia, blurred vision, hypertension, chest pain, and muscle weakness.
Question 25 Explanation:
Bronchodilators can produce the side effects listed in answer choice for a short time after the patient begins using them.
Question 26
I cannot participate in physical activities if I have asthma.
A
True
B
False
Question 27
In an acute severe attack of asthma, it is important to get a chest x-ray done to rule out:
A
A pleural effusion
B
A pneunothorax
C
Lung malignancy
D
COPD
Question 28
When does nocturnal asthma usually occur?
A
Early night
B
Near Dawn
C
2am-4am in the middle of the night
D
It does not exist
Question 29
Which answer best describes common outdoor Asthma triggers?
A
Changes in weather and temperature.
B
Pollen
C
Air pollution
D
All of the above
Question 30
Asthma is basically:
A
An infectious disease
B
An autoimmune disease
C
An atopic disease
D
A malignant disease
Question 31
Which answer is a true symptom of Asthma?
A
Emotional problems.
B
Clogging-the mucus blocks the airways and thus allows less air to pass through the airways
C
Swelling of the airways.
D
B & C are correct
Question 32
A child has been brought to the emergency room with an asthma attack. What signs and symptoms would the nurse expect to see?
A
A prolonged inspiratory time and a short expiratory time.
B
Frequent productive coughing of clear, frothy, thin mucus progressing to thick, tenacious mucus heard only on auscultation.
C
Hypoinflation of the alveoli with resulting poor gas exchange from increasingly shallow inspirations.
D
Swelling of the bronchial mucosa, with wheezes starting on expiration and spreading to continuous.
Question 32 Explanation:
Bronchi normally expand and lengthen during inspiration and shorten during expiration. Asthma causes spasm of the smooth muscles in the bronchi and bronchioles, resulting in an even tighter airway on exhalation and prolonged exhalation. Inspirations increase in rate in an effort to relieve hypoxia. At the beginning of the attack, the cough is nonproductive and results from bronchial edema. Then the mucus becomes profuse and rattly, with a cough producing frothy, clear sputum. Gas trapping is the central feature of asthma. It is caused by allowing more air to enter alveoli than can escape from them through the narrowed airways. Gas trapping also causes an increased depth and rate of respirations. The wheeze starts during the expiratory phase because of the extreme narrowing of the bronchus on exhalation. As obstruction increases, wheezes become more high pitched and continuous.
Question 33
A white female client is admitted to an acute care facility with a diagnosis of cerebrovascular accident (CVA). Her history reveals bronchial asthma, exogenous obesity, and iron deficiency anemia. Which history finding is a risk factor for CVA?
A
Caucasian race
B
Female sex
C
Obesity
D
Bronchial asthma
Question 33 Explanation:
Obesity is a risk factor for CVA. Other risk factors include a history of ischemic episodes, cardiovascular disease, diabetes mellitus, atherosclerosis of the cranial vessels, hypertension, polycythemia, smoking, hypercholesterolemia, oral contraceptive use, emotional stress, family history of CVA, and advancing age. The client’s race, sex, and bronchial asthma aren’t risk factors for CVA.
Question 34
Asthma is triggered by allergens such as pollen and animal furs.
A
True
B
False
Question 35
The nurse understands that a good snack for a 2 year old with a diagnosis of acute asthma would be:
A
Grapes
B
Apple slices
C
A glass of milk
D
A glass of cola
Question 35 Explanation:
Grapes is inappropriate because of its “skin” that can cause choking. A glass of milk is not a good snack because it’s the most common cause of Iron-deficiency anemia in children (milk contains few iron), A glass of cola is also not appropriate cause it contains complex sugar.
Question 36
Use your air conditioner to help filter the air coming into the center.
A
True
B
False
Question 37
In which age group of people is asthma the most common disease in?
A
Children
B
Teens
C
Adults
D
Elderly
Question 38
The nurse is caring for Kenneth experiencing an acute asthma attack. The client stops wheezing and breath sounds aren’t audible. The reason for this change is that:
A
The attack is over.
B
The airways are so swollen that no air cannot get through.
C
The swelling has decreased.
D
Crackles have replaced wheezes.
Question 38 Explanation:
During an acute attack, wheezing may stop and breath sounds become inaudible because the airways are so swollen that air can’t get through. If the attack is over and swelling has decreased, there would be no more wheezing and less emergent concern. Crackles do not replace wheezes during an acute asthma attack.
Question 39
The following drug cannot cause asthma:
A
Beta-blocker
B
Histamine
C
Ibuprofen
D
Atropine
Question 40
Kennedy with acute asthma showing inspiratory and expiratory wheezes and a decreased forced expiratory volume should be treated with which of the following classes of medication right away?
A
Beta-adrenergic blockers
B
Bronchodilators
C
Inhaled steroids
D
Oral steroids
Question 40 Explanation:
Bronchodilators are the first line of treatment for asthma because broncho-constriction is the cause of reduced airflow. Beta adrenergic blockers aren’t used to treat asthma and can cause bronchoconstriction. Inhaled oral steroids may be given to reduce the inflammation but aren’t used for emergency relief.
Question 41
There is no single cause for Asthma and currently, there is no cure for Asthma.
A
True
B
False
Question 42
All classroom pets should be banned to prevent Asthma triggers.
A
True
B
False
Question 42 Explanation:
Proteins in animal's skin flakes, urine, feces, saliva and hair can trigger asthma. Dogs, cats, rodents (including hamsters and guinea pigs) and other warm-blooded mammals can trigger Asthma in individuals with an allergy to animal dander. SO, load your class with the Asthma friendliest pets of all-FISH!
Question 43
Bronchoprovocation tests usually use histamine to challenge the airways. Besides histamine, ____________ can also be used:
A
Ipratropium bromide
B
Adrenocorticotrophic hormone
C
Prednisolone
D
Metracholine
Question 44
What can lead to an asthma attack?
A
Airway Obstruction
B
Airway Irritability
C
Inflammation
D
All of the above
Question 45
Which is not a potential side effect of bronchodilator drugs ?
A
Tremor
B
Oral thrush
C
Tachycardia
D
Anxiety
E
Headache
Question 46
Asthma has the greatest prevalence in which two populations:
A
Males aged 25-44 years & females 10-14 years
B
Males aged 15-19 years & females aged 10-14 years
C
Males aged 10-14 years & females aged 20-24 years
D
Males aged 20-24 years & females aged 25-44 years
Question 47
Dust and dust mites can trigger Asthma too. What are ways to reduce the chances?
A
Keep classrooms are clean and clutter free as possible.
B
Dust furniture regularly with a damp cloth and allow sufficient time to dry.
C
Wash pillows, blankets and stuffed toys often.
D
All of the above.
Question 48
Which of the following is NOT a risk factor for the development of asthma?
A
Parental history of asthma
B
Physician diagnosed atopic dermatitis
C
Peripheral eosinophilia and allergic rhinitis
D
Wheezing apart from colds and allergic rhinitis
E
Recurrent otitis media
Question 49
What are the two categories of pharmalogical agents used in the treatment of asthma
A
B2 adrenoreceptor antagonists and bronchodilators
B
Anti-inflammatory and glucocorticoids
C
Inhaled medications and oral medications
D
Bronchodilators and anti-inflammatory
Question 50
Which is not a hallmark feature of asthma?
A
Oedema
B
Dynamic airway collapse
C
Bronchospasm
D
Epithelial Damage
Question 51
Common signs and symptoms include:
Excessive coughing
Wheezing
Chest Tightness
Shortness of breath
Waking at night
A
True
B
False
Question 52
Cockroaches can trigger Asthma attacks.
A
True
B
False
Question 53
The primary physiological alteration in the development of asthma is:
A
Bronchiolar inflammation and dyspnea
B
Hypersecretion of abnormally viscous mucus
C
Infectious processes causing mucosal edema
D
Spasm of bronchiolar smooth muscle
Question 53 Explanation:
Asthma is the presence of bronchiolar spasms. This spasm can be brought on by allergies or anxiety. Answer A is incorrect because the primary physiological alteration is not inflammation. Answer B is incorrect because there is the production of abnormally viscous mucus, not a primary alteration. Answer C is incorrect because infection is not primary to asthma.
Question 54
Which of the following is not considered a COPD related disease?
A
Bronchiectasis
B
Bronchial asthma
C
Bronchitis
D
Bronchial hypotension
Question 55
A good inhalation technique can ensure that the medication is delivered to the airways of the lungs.
A
True
B
False
Question 56
Simple instrument to roughly determine lung function is a:
A
Barometer
B
Manometer
C
Peak flow meter
D
Sphygmomanometer
Question 57
What should you do when you have an asthma?
A
Overuse asthma medication
B
Smoke
C
To use the medicines as prescribed
D
Not control diet
Question 58
Mark, a 7-year-old client is brought to the emergency department. He’s tachypneic and afebrile and has a respiratory rate of 36 breaths/minute and has a nonproductive cough. He recently had a cold. Form this history; the client may have which of the following conditions?
A
Acute asthma
B
Bronchial pneumonia
C
Chronic obstructive pulmonary disease (COPD)
D
Emphysema
Question 58 Explanation:
Based on the client’s history and symptoms, acute asthma is the most likely diagnosis. He’s unlikely to have bronchial pneumonia without a productive cough and fever and he’s too young to have developed (COPD) and emphysema.
Question 59
Which of the following statements by the family of a child with asthma indicates a need for additional teaching?
A
“We need to identify what things triggers his attacks”
B
“He is to use bronchodilator inhaler before steroid inhaler”
C
“We’ll make sure he avoids exercise to prevent asthma attacks”
D
“he should increase his fluid intake regularly to thin secretions”
Question 59 Explanation:
Asthmatic children don’t have to avoid exercise. They can participate on physical activities as tolerated. Using a bronchodilator before administering steroids is correct because steroids are just anti-inflammatory and they don’t have effects on the dilation of the bronchioles. OF course letters A and B are obviously correct.
Question 60
What is asthma?
A
Heart failure
B
A mild ailment
C
An intestinal illness
D
A chronic respiratory disease
Question 61
Asthma can be life-threatening.
A
True
B
False
Question 62
Perfumes and cleaning products can be an Asthma trigger.
A
True
B
False
Question 62 Explanation:
Try not to wear perfumes to school. Limit the use of scented aerosols in the center. Try to use non-aerosol cleaners while Asthmatic children are present.
Question 63
A black male client with asthma seeks emergency care for acute respiratory distress. Because of this client’s dark skin, the nurse should assess for cyanosis by inspecting the:
A
lips.
B
mucous membranes.
C
nail beds.
D
earlobes.
Question 63 Explanation:
Skin color doesn’t affect the mucous membranes. The lips, nail beds, and earlobes are less reliable indicators of cyanosis because they’re affected by skin color.
Question 64
What of these is not a characteristic of Allergic asthma?
A
Starts in childhood or adolescence
B
Triggered by specific allergens (ie: dust mites and pollen)
C
Presents with bronchoconstriction and inflammation of the airways
D
Is a consequence of viral infection
Question 65
Symptoms of asthma include wheezing, coughing and breathing difficulty.
A
True
B
False
Question 66
Lisa is newly diagnosed with asthma and is being discharged from the hospital after an episode of status asthmaticus. Discharge teaching should include which of the following:
A
Specific instructions on staying cal during an attack
B
The relationship of symptoms and a specific trigger such as physical exercise
C
Incidence of status asthmaticus in children and teens
D
Limitations in sports that will be imposed by the illness
Question 66 Explanation:
COPD clients have low oxygen and high carbon dioxide levels. Therefore, hypoxia is the main stimulus for ventilation is persons with chronic hypercapnea. Increasing the level of oxygen would decrease the stimulus to breathe.
Question 67
Asthma is....
A
Localized, irreversible dilation of part of the bronchial tree due to destruction of the muscle and elastic tissue
B
A persistent cough that produces sputum and mucus for at least 3 months of the year, two years in succession
C
A chronic inflammatory disorder of the airways associated with episodes of wheezing, breathlessness, chest tightness and coughing
D
Collapse and closure of alveoli resulting in reduced or absent gas exchange affecting all of part of the lung
Question 68
Inhaled steroids(preventer/controller) will cause major side effects at recommended dosages.
A
True
B
False
Question 69
Crying, laughing hard or yelling can trigger Asthma.
A
True
B
False
Question 70
Which contraindication should the nurse assess for prior to giving a child immunization?
A
Mild cold symptoms
B
Chronic asthma
C
Depressed immune system
D
Allergy to eggs
Question 70 Explanation:
Children who have a depressed immune system related to HIV or chemotherapy should not be given routine immunizations.
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MSN Exam for Asthma (EM)*
Choose the letter of the correct answer. You got 70 minutes to finish the exam .Good luck!
Start
Congratulations - you have completed MSN Exam for Asthma (EM)*.
You scored %%SCORE%% out of %%TOTAL%%.
Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
The primary physiological alteration in the development of asthma is:
A
Bronchiolar inflammation and dyspnea
B
Hypersecretion of abnormally viscous mucus
C
Infectious processes causing mucosal edema
D
Spasm of bronchiolar smooth muscle
Question 1 Explanation:
Asthma is the presence of bronchiolar spasms. This spasm can be brought on by allergies or anxiety. Answer A is incorrect because the primary physiological alteration is not inflammation. Answer B is incorrect because there is the production of abnormally viscous mucus, not a primary alteration. Answer C is incorrect because infection is not primary to asthma.
Question 2
Evidence suggests there are 3 crucial factors in the primary prevention of asthma. These include ..
A
Avoidance of household pets, obesity and allergen avoidance
B
Exposure to environmental tobacco smoke, breast feeding during infancy and allergen avoidance
C
Drug therapy with associated disease, avoidance of sedentary behaviour and exposure to environmental tobacco smoke
D
Breastfeeding during infancy, residing at least 20 km outside a major city and gaining at least 3 hours of oxygen from outdoors per day
Question 3
The following are helpful in determining the severity of an acute attack except:
A
Use of accersoy muscles of respiration
B
Ability to complete sentences
C
Peak expiratory flow rate
D
Pedal edema
Question 4
Asthma is triggered by allergens such as pollen and animal furs.
A
True
B
False
Question 5
Lisa is newly diagnosed with asthma and is being discharged from the hospital after an episode of status asthmaticus. Discharge teaching should include which of the following:
A
Specific instructions on staying cal during an attack
B
The relationship of symptoms and a specific trigger such as physical exercise
C
Incidence of status asthmaticus in children and teens
D
Limitations in sports that will be imposed by the illness
Question 5 Explanation:
COPD clients have low oxygen and high carbon dioxide levels. Therefore, hypoxia is the main stimulus for ventilation is persons with chronic hypercapnea. Increasing the level of oxygen would decrease the stimulus to breathe.
Question 6
The characteristic feature of persistent asthma is:
A
Family history of disease
B
Airway inflammation
C
Need for oral steroids
D
Nocturnal wheezing
Question 7
Use your air conditioner to help filter the air coming into the center.
A
True
B
False
Question 8
Which of the following statements by the family of a child with asthma indicates a need for additional teaching?
A
“We need to identify what things triggers his attacks”
B
“He is to use bronchodilator inhaler before steroid inhaler”
C
“We’ll make sure he avoids exercise to prevent asthma attacks”
D
“he should increase his fluid intake regularly to thin secretions”
Question 8 Explanation:
Asthmatic children don’t have to avoid exercise. They can participate on physical activities as tolerated. Using a bronchodilator before administering steroids is correct because steroids are just anti-inflammatory and they don’t have effects on the dilation of the bronchioles. OF course letters A and B are obviously correct.
Question 9
Asthma can be life-threatening.
A
True
B
False
Question 10
Crying, laughing hard or yelling can trigger Asthma.
A
True
B
False
Question 11
In an acute severe attack of asthma, it is important to get a chest x-ray done to rule out:
A
A pleural effusion
B
A pneunothorax
C
Lung malignancy
D
COPD
Question 12
The following drug cannot cause asthma:
A
Beta-blocker
B
Histamine
C
Ibuprofen
D
Atropine
Question 13
All classroom pets should be banned to prevent Asthma triggers.
A
True
B
False
Question 13 Explanation:
Proteins in animal's skin flakes, urine, feces, saliva and hair can trigger asthma. Dogs, cats, rodents (including hamsters and guinea pigs) and other warm-blooded mammals can trigger Asthma in individuals with an allergy to animal dander. SO, load your class with the Asthma friendliest pets of all-FISH!
Question 14
Asthma has the greatest prevalence in which two populations:
A
Males aged 25-44 years & females 10-14 years
B
Males aged 15-19 years & females aged 10-14 years
C
Males aged 10-14 years & females aged 20-24 years
D
Males aged 20-24 years & females aged 25-44 years
Question 15
Asthma is....
A
Localized, irreversible dilation of part of the bronchial tree due to destruction of the muscle and elastic tissue
B
A persistent cough that produces sputum and mucus for at least 3 months of the year, two years in succession
C
A chronic inflammatory disorder of the airways associated with episodes of wheezing, breathlessness, chest tightness and coughing
D
Collapse and closure of alveoli resulting in reduced or absent gas exchange affecting all of part of the lung
Question 16
Which of the following tests cannot detect airway inflammation?
A
Bronchial mucosal biopsy
B
Sputum eosinophil counts
C
Bronchoalveolar lavage
D
Spirometry
Question 17
Which answer is a true symptom of Asthma?
A
Emotional problems.
B
Clogging-the mucus blocks the airways and thus allows less air to pass through the airways
C
Swelling of the airways.
D
B & C are correct
Question 18
How can seasonal asthma come about?
A
Inhalation or exposure to trees, grasses or flowers releasing pollen into the air.
B
Inhalation of tobacco smoke
C
Exposure to paint thinners or dust
Question 19
There is no single cause for Asthma and currently, there is no cure for Asthma.
A
True
B
False
Question 20
A white female client is admitted to an acute care facility with a diagnosis of cerebrovascular accident (CVA). Her history reveals bronchial asthma, exogenous obesity, and iron deficiency anemia. Which history finding is a risk factor for CVA?
A
Caucasian race
B
Female sex
C
Obesity
D
Bronchial asthma
Question 20 Explanation:
Obesity is a risk factor for CVA. Other risk factors include a history of ischemic episodes, cardiovascular disease, diabetes mellitus, atherosclerosis of the cranial vessels, hypertension, polycythemia, smoking, hypercholesterolemia, oral contraceptive use, emotional stress, family history of CVA, and advancing age. The client’s race, sex, and bronchial asthma aren’t risk factors for CVA.
Question 21
Staff who smoke on their personal time cannot harm children with Asthma.
A
True
B
False
Question 21 Explanation:
Secondhand smoke can be present on your clothing therefore exposing children to it. Never smoke in clothing you wear to work.
Question 22
Which statement is true about Asthma:
A
Asthma is one of the most common chronic diseases nationwide, impacting the lives and families of over 7 million children.
B
Asthma is the third-ranking cause of hospitalization among children under 15.
C
An average of one our of every 10 school-aged children has asthma and 10.5 million school days are missed each year due to Asthmas
D
All of the above is true
Question 23
A client with asthma has low pitched wheezes present on the final half of exhalation. One hour later the client has high pitched wheezes extending throughout exhalation. This change in assessment indicates to the nurse that the client
A
Has increased airway obstruction
B
Has improved airway obstruction
C
Needs to be suctioned
D
Exhibits hyperventilation
Question 23 Explanation:
The higher pitched a sound is, the more narrow the airway. Therefore, the obstruction has increased or worsened. With no evidence of secretions no support exists to indicate the need for suctioning.
Question 24
Carol Smith is using bronchodilators for asthma. The side effects of these drugs that you need to monitor this patient for include:
A
tachycardia, nausea, vomiting, heart palpitations, inability to sleep, restlessness, and seizures.
B
tachycardia, headache, dyspnea, temp . 101 F, and wheezing.
C
blurred vision, tachycardia, hypertension, headache, insomnia, and oliguria.
D
restlessness, insomnia, blurred vision, hypertension, chest pain, and muscle weakness.
Question 24 Explanation:
Bronchodilators can produce the side effects listed in answer choice for a short time after the patient begins using them.
Question 25
Perfumes and cleaning products can be an Asthma trigger.
A
True
B
False
Question 25 Explanation:
Try not to wear perfumes to school. Limit the use of scented aerosols in the center. Try to use non-aerosol cleaners while Asthmatic children are present.
Question 26
What should you do when you have an asthma?
A
Overuse asthma medication
B
Smoke
C
To use the medicines as prescribed
D
Not control diet
Question 27
When does nocturnal asthma usually occur?
A
Early night
B
Near Dawn
C
2am-4am in the middle of the night
D
It does not exist
Question 28
Which of the following is NOT a risk factor for the development of asthma?
A
Parental history of asthma
B
Physician diagnosed atopic dermatitis
C
Peripheral eosinophilia and allergic rhinitis
D
Wheezing apart from colds and allergic rhinitis
E
Recurrent otitis media
Question 29
Which finding would alert a nurse that a hospitalized 6-year-old child is at risk for a severe asthma exacerbation?
A
Oxygen saturation of 95%
B
Mild work of breathing
C
Absence of intercostals or substernal retractions
D
History of steroid-dependent asthma
Question 29 Explanation:
A history of steroid-dependent asthma, a contributing factor to this client’s high-risk status, requires the nurse to treat the situation as a severe exacerbation regardless of the severity of the current episode. An oxygen saturation of 95%, mild work of breathing, and absence of intercostals or substernal retractions are all normal findings.
Question 30
What can lead to an asthma attack?
A
Airway Obstruction
B
Airway Irritability
C
Inflammation
D
All of the above
Question 31
True/False: Gastroesophageal reflux should be considered in a patient who has poorly controlled asthma, with a significant nocturnal component.
A
True
B
False
Question 31 Explanation:
A significant correlation between nocturnal asthma and gastroesophageal reflux has been observed. The patient may not complain of epigastric burning or have reflux symptoms. Cough may be the only symptom.
Question 32
Which of the following is not considered a COPD related disease?
A
Bronchiectasis
B
Bronchial asthma
C
Bronchitis
D
Bronchial hypotension
Question 33
Simple instrument to roughly determine lung function is a:
A
Barometer
B
Manometer
C
Peak flow meter
D
Sphygmomanometer
Question 34
Common signs and symptoms include:
Excessive coughing
Wheezing
Chest Tightness
Shortness of breath
Waking at night
A
True
B
False
Question 35
An 8-year-old boy with asthma is brought to the clinic for check up. The mother asks the nurse if the treatment given to her son is effective. What would be the appropriate response of the nurse?
A
I will review first the child’s height on a growth chart to know if the treatment is working
B
I will review first the child’s weight on a growth chart to know if the treatment is working
C
I will review first the number of prescriptions refills the child has required over the last 6 months to give you an accurate answer
D
I will review first the number of times the child has seen the pediatrician during the last 6 months to give you an accurate answer
Question 35 Explanation:
Reviewing the number of prescription refills the child has required over the last 6 months would be the best indicator of how well controlled and thus how effective the child’s asthma treatment is. Breakthrough wheezing, shortness of breath, and upper respiratory infections would require that the child take additional medication. This would be reflected in the number of prescription refills.
Question 36
The following bronchodilator is most commonly used when doing a reversibility test:
A
Salbutamol
B
Adrenaline
C
Theophylline anhydrous
D
Atropine
Question 37
What of these is not a characteristic of Allergic asthma?
A
Starts in childhood or adolescence
B
Triggered by specific allergens (ie: dust mites and pollen)
C
Presents with bronchoconstriction and inflammation of the airways
D
Is a consequence of viral infection
Question 38
What are the two categories of pharmalogical agents used in the treatment of asthma
A
B2 adrenoreceptor antagonists and bronchodilators
B
Anti-inflammatory and glucocorticoids
C
Inhaled medications and oral medications
D
Bronchodilators and anti-inflammatory
Question 39
Which contraindication should the nurse assess for prior to giving a child immunization?
A
Mild cold symptoms
B
Chronic asthma
C
Depressed immune system
D
Allergy to eggs
Question 39 Explanation:
Children who have a depressed immune system related to HIV or chemotherapy should not be given routine immunizations.
Question 40
Which is not a potential side effect of bronchodilator drugs ?
A
Tremor
B
Oral thrush
C
Tachycardia
D
Anxiety
E
Headache
Question 41
Bronchoprovocation tests usually use histamine to challenge the airways. Besides histamine, ____________ can also be used:
A
Ipratropium bromide
B
Adrenocorticotrophic hormone
C
Prednisolone
D
Metracholine
Question 42
What is asthma?
A
Heart failure
B
A mild ailment
C
An intestinal illness
D
A chronic respiratory disease
Question 43
Asthma causes the airways to:
A
Constrict
B
Become imflammed
C
Become lined with a large amount of mucus
D
All of the above
Question 44
Which of the following is true?
A
A preventer is used to relieve asthma attacks.
B
A reliever is used to relieve asthma attacks.
Question 45
Mark, a 7-year-old client is brought to the emergency department. He’s tachypneic and afebrile and has a respiratory rate of 36 breaths/minute and has a nonproductive cough. He recently had a cold. Form this history; the client may have which of the following conditions?
A
Acute asthma
B
Bronchial pneumonia
C
Chronic obstructive pulmonary disease (COPD)
D
Emphysema
Question 45 Explanation:
Based on the client’s history and symptoms, acute asthma is the most likely diagnosis. He’s unlikely to have bronchial pneumonia without a productive cough and fever and he’s too young to have developed (COPD) and emphysema.
Question 46
A 19-year-old patient comes to the ED with acute asthma. His respiratory rate is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions should you take first?
A
Take a full medical history.
B
Give a bronchodilator by nebulizer.
C
Apply a cardiac monitor to the patient.
D
Provide emotional support for the patient
Question 46 Explanation:
The patient having an acute asthma attack needs more oxygen delivered to his lungs and body. Nebulized bronchodilators open airways and increase the amount of oxygen delivered. The patient may not need cardiac monitoring because he’s only 19 years old, unless he has a medical history of cardiac problems.
Question 47
Symptoms of asthma include wheezing, coughing and breathing difficulty.
A
True
B
False
Question 48
Kennedy with acute asthma showing inspiratory and expiratory wheezes and a decreased forced expiratory volume should be treated with which of the following classes of medication right away?
A
Beta-adrenergic blockers
B
Bronchodilators
C
Inhaled steroids
D
Oral steroids
Question 48 Explanation:
Bronchodilators are the first line of treatment for asthma because broncho-constriction is the cause of reduced airflow. Beta adrenergic blockers aren’t used to treat asthma and can cause bronchoconstriction. Inhaled oral steroids may be given to reduce the inflammation but aren’t used for emergency relief.
Question 49
The parameter to detect reversibility in airflow obstruction on a spirometry test is:
A
FEV1
B
FVC
C
MVV
D
RV
Question 50
Asthma is caused by inflammation of the airways in the lungs.
A
True
B
False
Question 51
A good inhalation technique can ensure that the medication is delivered to the airways of the lungs.
A
True
B
False
Question 52
The key role of a physiotherapist in treatment of asthma is to ...
A
Provide education to the patient about the disease and treatment options
B
Administering and educating the patient about airway clearance techniques
C
Provide education about exercise and the option of pulmonary rehabilitation classes
D
All of the above
E
None of the above
Question 53
Cockroaches can trigger Asthma attacks.
A
True
B
False
Question 54
I cannot participate in physical activities if I have asthma.
A
True
B
False
Question 55
Inhaled steroids(preventer/controller) will cause major side effects at recommended dosages.
A
True
B
False
Question 56
The nurse is caring for Kenneth experiencing an acute asthma attack. The client stops wheezing and breath sounds aren’t audible. The reason for this change is that:
A
The attack is over.
B
The airways are so swollen that no air cannot get through.
C
The swelling has decreased.
D
Crackles have replaced wheezes.
Question 56 Explanation:
During an acute attack, wheezing may stop and breath sounds become inaudible because the airways are so swollen that air can’t get through. If the attack is over and swelling has decreased, there would be no more wheezing and less emergent concern. Crackles do not replace wheezes during an acute asthma attack.
Question 57
In which age group of people is asthma the most common disease in?
A
Children
B
Teens
C
Adults
D
Elderly
Question 58
In those with asthma, which of the following does not contribute to inspiratory muscle weakness ?
A
Increased use of steroid based medication
B
Dyspnea
C
Reduced exercise tolerance
D
Inflammatory processes
Question 59
A 5 year old AA male comes in with a history of asthma, but currently is not on any medication. In the history, you find out he uses his Albuterol MDI with spacer once every two weeks during the day. He does wake up 2-3 times per week coughing at night. How would you classify his asthma?
A
Intermittent
B
Mild Persistent
C
Moderate Persistent
D
Severe Persistent
Question 59 Explanation:
Moderate persistent, great than one night per week of symptoms bumps him to Moderate persistent
Question 60
A black male client with asthma seeks emergency care for acute respiratory distress. Because of this client’s dark skin, the nurse should assess for cyanosis by inspecting the:
A
lips.
B
mucous membranes.
C
nail beds.
D
earlobes.
Question 60 Explanation:
Skin color doesn’t affect the mucous membranes. The lips, nail beds, and earlobes are less reliable indicators of cyanosis because they’re affected by skin color.
Question 61
A slightly obese female client with a history of allergy-induced asthma, hypertension, and mitral valve prolapse is admitted to an acute care facility for elective surgery. The nurse obtains a complete history and performs a thorough physical examination, paying special attention to the cardiovascular and respiratory systems. When percussing the client’s chest wall, the nurse expects to elicit:
A
Resonant sounds.
B
Hyperresonant sounds.
C
Dull sounds.
D
Flat sounds.
Question 61 Explanation:
When percussing the chest wall, the nurse expects to elicit resonant sounds — low-pitched, hollow sounds heard over normal lung tissue. Hyperresonant sounds indicate increased air in the lungs or pleural space; they’re louder and lower pitched than resonant sounds. Although hyperresonant sounds occur in such disorders as emphysema and pneumothorax, they may be normal in children and very thin adults. Dull sounds, normally heard only over the liver and heart, may occur over dense lung tissue, such as from consolidation or a tumor. Dull sounds are thudlike and of medium pitch. Flat sounds, soft and high-pitched, are heard over airless tissue and can be replicated by percussing the thigh or a bony structure.
Question 62
A child has been brought to the emergency room with an asthma attack. What signs and symptoms would the nurse expect to see?
A
A prolonged inspiratory time and a short expiratory time.
B
Frequent productive coughing of clear, frothy, thin mucus progressing to thick, tenacious mucus heard only on auscultation.
C
Hypoinflation of the alveoli with resulting poor gas exchange from increasingly shallow inspirations.
D
Swelling of the bronchial mucosa, with wheezes starting on expiration and spreading to continuous.
Question 62 Explanation:
Bronchi normally expand and lengthen during inspiration and shorten during expiration. Asthma causes spasm of the smooth muscles in the bronchi and bronchioles, resulting in an even tighter airway on exhalation and prolonged exhalation. Inspirations increase in rate in an effort to relieve hypoxia. At the beginning of the attack, the cough is nonproductive and results from bronchial edema. Then the mucus becomes profuse and rattly, with a cough producing frothy, clear sputum. Gas trapping is the central feature of asthma. It is caused by allowing more air to enter alveoli than can escape from them through the narrowed airways. Gas trapping also causes an increased depth and rate of respirations. The wheeze starts during the expiratory phase because of the extreme narrowing of the bronchus on exhalation. As obstruction increases, wheezes become more high pitched and continuous.
Question 63
Which is not a hallmark feature of asthma?
A
Oedema
B
Dynamic airway collapse
C
Bronchospasm
D
Epithelial Damage
Question 64
Dust and dust mites can trigger Asthma too. What are ways to reduce the chances?
A
Keep classrooms are clean and clutter free as possible.
B
Dust furniture regularly with a damp cloth and allow sufficient time to dry.
C
Wash pillows, blankets and stuffed toys often.
D
All of the above.
Question 65
Which answer best describes common outdoor Asthma triggers?
A
Changes in weather and temperature.
B
Pollen
C
Air pollution
D
All of the above
Question 66
If a person suffers from asthma, what are the likely symptoms he/she may have?
A
Sore, swollen and sensitive airway linings.
B
Weak breathing
C
Fast and unsteady pulse
D
Cancer in the airway
Question 67
Which of the following respiratory condition is always considered a medical emergency?
A
Laryngeotracheobronchitis (LTB)
B
Epiglottitis
C
Asthma
D
Cystic Fibrosis
Question 67 Explanation:
Acute and sever inflammation of the epiglottis can cause life threatening airway obstruction, that is why its always treated as a medical emergency. NSG intervention : Prepare tracheostomy set at bed side.
LTB, can also cause airway obstruction but its not an emergency. Asthma is also not an emergency (ung status asthmaticus ang kaylangan ng prompt treatment). CF is a chronic disease, so its not a medical emergency.
Question 68
The nurse understands that a good snack for a 2 year old with a diagnosis of acute asthma would be:
A
Grapes
B
Apple slices
C
A glass of milk
D
A glass of cola
Question 68 Explanation:
Grapes is inappropriate because of its “skin” that can cause choking. A glass of milk is not a good snack because it’s the most common cause of Iron-deficiency anemia in children (milk contains few iron), A glass of cola is also not appropriate cause it contains complex sugar.
Question 69
Asthma is basically:
A
An infectious disease
B
An autoimmune disease
C
An atopic disease
D
A malignant disease
Question 70
True/False: If a patient has had coughing or wheezing for over one year, the possiblity of a foreign body is essentially ruled out.
A
True
B
False
Question 70 Explanation:
The acute cough and/or wheeze caused by a foreign body in the lower respiratory tract may diminish over time only to recur later and present as chronic cough and/or persistent wheezing.
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1) Which is not a potential side effect of bronchodilator drugs ?
Tremor
Oral thrush
Tachycardia
Anxiety
Headache
2) What should you do when you have an asthma?
Overuse asthma medication
Smoke
To use the medicines as prescribed
Not control diet
3) In which age group of people is asthma the most common disease in?
Children
Teens
Adults
Elderly
4) The following drug cannot cause asthma:
Beta-blocker
Histamine
Ibuprofen
Atropine
5) Which of the following respiratory condition is always considered a medical emergency?
Laryngeotracheobronchitis (LTB)
Epiglottitis
Asthma
Cystic Fibrosis
6) The following bronchodilator is most commonly used when doing a reversibility test:
Salbutamol
Adrenaline
Theophylline anhydrous
Atropine
7) A slightly obese female client with a history of allergy-induced asthma, hypertension, and mitral valve prolapse is admitted to an acute care facility for elective surgery. The nurse obtains a complete history and performs a thorough physical examination, paying special attention to the cardiovascular and respiratory systems. When percussing the client’s chest wall, the nurse expects to elicit:
Resonant sounds.
Hyperresonant sounds.
Dull sounds.
Flat sounds.
8) Which contraindication should the nurse assess for prior to giving a child immunization?
Mild cold symptoms
Chronic asthma
Depressed immune system
Allergy to eggs
9) Common signs and symptoms include: Excessive coughing, Wheezing Chest, Tightness Shortness of breath, Waking at night.
True
False
10) Asthma is basically:
An infectious disease
An autoimmune disease
An atopic disease
A malignant disease
11) Use your air conditioner to help filter the air coming into the center.
True
False
12) What is asthma?
Heart failure
A mild ailment
An intestinal illness
A chronic respiratory disease
13) Cockroaches can trigger Asthma attacks.
True
False
14) Dust and dust mites can trigger Asthma too. What are ways to reduce the chances?
Keep classrooms are clean and clutter free as possible.
Dust furniture regularly with a damp cloth and allow sufficient time to dry.
Wash pillows, blankets and stuffed toys often.
All of the above.
15) Inhaled steroids(preventer/controller) will cause major side effects at recommended dosages.
True
False
16) Which of the following is not considered a COPD related disease?
Bronchiectasis
Bronchial asthma
Bronchitis
Bronchial hypotension
17) A 19-year-old patient comes to the ED with acute asthma. His respiratory rate is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions should you take first?
Take a full medical history.
Give a bronchodilator by nebulizer.
Apply a cardiac monitor to the patient.
Provide emotional support for the patient
18) Which answer is a true symptom of Asthma?
Emotional problems.
Clogging-the mucus blocks the airways and thus allows less air to pass through the airways
Swelling of the airways.
B & C are correct
19) The parameter to detect reversibility in airflow obstruction on a spirometry test is:
FEV1
FVC
MVV
RV
20) In those with asthma, which of the following does not contribute to inspiratory muscle weakness ?
Increased use of steroid based medication
Dyspnea
Reduced exercise tolerance
Inflammatory processes
21) True/False: Gastroesophageal reflux should be considered in a patient who has poorly controlled asthma, with a significant nocturnal component.
True
False
22) I cannot participate in physical activities if I have asthma.
True
False
23) Which of the following statements by the family of a child with asthma indicates a need for additional teaching?
“We need to identify what things triggers his attacks”
“He is to use bronchodilator inhaler before steroid inhaler”
“We’ll make sure he avoids exercise to prevent asthma attacks”
“he should increase his fluid intake regularly to thin secretions”
24) The following are helpful in determining the severity of an acute attack except:
Use of accersoy muscles of respiration
Ability to complete sentences
Peak expiratory flow rate
Pedal edema
25) A good inhalation technique can ensure that the medication is delivered to the airways of the lungs.
True
False
26) Symptoms of asthma include wheezing, coughing and breathing difficulty.
True
False
27) A white female client is admitted to an acute care facility with a diagnosis of cerebrovascular accident (CVA). Her history reveals bronchial asthma, exogenous obesity, and iron deficiency anemia. Which history finding is a risk factor for CVA?
Caucasian race
Female sex
Obesity
Bronchial asthma
28) Asthma is triggered by allergens such as pollen and animal furs.
True
False
29) Carol Smith is using bronchodilators for asthma. The side effects of these drugs that you need to monitor this patient for include:
tachycardia, nausea, vomiting, heart palpitations, inability to sleep, restlessness, and seizures.
tachycardia, headache, dyspnea, temp . 101 F, and wheezing.
blurred vision, tachycardia, hypertension, headache, insomnia, and oliguria.
restlessness, insomnia, blurred vision, hypertension, chest pain, and muscle weakness.
30) What of these is not a characteristic of Allergic asthma?
Starts in childhood or adolescence
Triggered by specific allergens (ie: dust mites and pollen)
Presents with bronchoconstriction and inflammation of the airways
Is a consequence of viral infection
31) Bronchoprovocation tests usually use histamine to challenge the airways. Besides histamine, ____________ can also be used:
Ipratropium bromide
Adrenocorticotrophic hormone
Prednisolone
Metracholine
32) Lisa is newly diagnosed with asthma and is being discharged from the hospital after an episode of status asthmaticus. Discharge teaching should include which of the following:
Limitations in sports that will be imposed by the illness
Specific instructions on staying cal during an attack
The relationship of symptoms and a specific trigger such as physical exercise
Incidence of status asthmaticus in children and teens
33) True/False: If a patient has had coughing or wheezing for over one year, the possiblity of a foreign body is essentially ruled out.
True
False
34) Which of the following is NOT a risk factor for the development of asthma?
Parental history of asthma
Physician diagnosed atopic dermatitis
Peripheral eosinophilia and allergic rhinitis
Wheezing apart from colds and allergic rhinitis
Recurrent otitis media
35) The nurse understands that a good snack for a 2 year old with a diagnosis of acute asthma would be:
Grapes
Apple slices
A glass of milk
A glass of cola
36) Asthma is caused by inflammation of the airways in the lungs.
True
False
37) What can lead to an asthma attack?
Airway Obstruction
Airway Irritability
Inflammation
All of the above
38) Which of the following is true?
A preventer is used to relieve asthma attacks.
A reliever is used to relieve asthma attacks.
39) Crying, laughing hard or yelling can trigger Asthma.
True
False
40) Evidence suggests there are 3 crucial factors in the primary prevention of asthma. These include ..
Avoidance of household pets, obesity and allergen avoidance
Exposure to environmental tobacco smoke, breast feeding during infancy and allergen avoidance
Drug therapy with associated disease, avoidance of sedentary behaviour and exposure to environmental tobacco smoke
Breastfeeding during infancy, residing at least 20 km outside a major city and gaining at least 3 hours of oxygen from outdoors per day
41) Mark, a 7-year-old client is brought to the emergency department. He’s tachypneic and afebrile and has a respiratory rate of 36 breaths/minute and has a nonproductive cough. He recently had a cold. Form this history; the client may have which of the following conditions?
Acute asthma
Bronchial pneumonia
Chronic obstructive pulmonary disease (COPD)
Emphysema
42) Which is not a hallmark feature of asthma?
Oedema
Dynamic airway collapse
Bronchospasm
Epithelial Damage
43) Kennedy with acute asthma showing inspiratory and expiratory wheezes and a decreased forced expiratory volume should be treated with which of the following classes of medication right away?
Beta-adrenergic blockers
Bronchodilators
Inhaled steroids
Oral steroids
44) When does nocturnal asthma usually occur?
Early night
Near Dawn
2am-4am in the middle of the night
It does not exist
45) Perfumes and cleaning products can be an Asthma trigger.
True
False
46) All classroom pets should be banned to prevent Asthma triggers.
True
False
47) Staff who smoke on their personal time cannot harm children with Asthma.
True
False
48) A child has been brought to the emergency room with an asthma attack. What signs and symptoms would the nurse expect to see?
A prolonged inspiratory time and a short expiratory time.
Frequent productive coughing of clear, frothy, thin mucus progressing to thick, tenacious mucus heard only on auscultation.
Hypoinflation of the alveoli with resulting poor gas exchange from increasingly shallow inspirations.
Swelling of the bronchial mucosa, with wheezes starting on expiration and spreading to continuous.
49) Asthma has the greatest prevalence in which two populations:
Males aged 25-44 years & females 10-14 years
Males aged 15-19 years & females aged 10-14 years
Males aged 10-14 years & females aged 20-24 years
Males aged 20-24 years & females aged 25-44 years
50) What are the two categories of pharmalogical agents used in the treatment of asthma
B2 adrenoreceptor antagonists and bronchodilators
Anti-inflammatory and glucocorticoids
Inhaled medications and oral medications
Bronchodilators and anti-inflammatory
51) There is no single cause for Asthma and currently, there is no cure for Asthma.
True
False
52) Which answer best describes common outdoor Asthma triggers?
Changes in weather and temperature.
Pollen
Air pollution
All of the above
53) A 5 year old AA male comes in with a history of asthma, but currently is not on any medication. In the history, you find out he uses his Albuterol MDI with spacer once every two weeks during the day. He does wake up 2-3 times per week coughing at night. How would you classify his asthma?
Intermittent
Mild Persistent
Moderate Persistent
Severe Persistent
54) Which finding would alert a nurse that a hospitalized 6-year-old child is at risk for a severe asthma exacerbation?
Oxygen saturation of 95%
Mild work of breathing
Absence of intercostals or substernal retractions
History of steroid-dependent asthma
55) The characteristic feature of persistent asthma is:
Family history of disease
Airway inflammation
Need for oral steroids
Nocturnal wheezing
56) Which statement is true about Asthma:
Asthma is one of the most common chronic diseases nationwide, impacting the lives and families of over 7 million children.
Asthma is the third-ranking cause of hospitalization among children under 15.
An average of one our of every 10 school-aged children has asthma and 10.5 million school days are missed each year due to Asthmas
All of the above is true
57) The primary physiological alteration in the development of asthma is:
Bronchiolar inflammation and dyspnea
Hypersecretion of abnormally viscous mucus
Infectious processes causing mucosal edema
Spasm of bronchiolar smooth muscle
58) A black client with asthma seeks emergency care for acute respiratory distress. Because of this client’s dark skin, the nurse should assess for cyanosis by inspecting the:
Lips.
Mucous membranes.
Nail beds.
Earlobes.
59) A client with asthma has low pitched wheezes present on the final half of exhalation. One hour later the client has high pitched wheezes extending throughout exhalation. This change in assessment indicates to the nurse that the client
Has increased airway obstruction
Has improved airway obstruction
Needs to be suctioned
Exhibits hyperventilation
60) Simple instrument to roughly determine lung function is a:
Barometer
Manometer
Peak flow meter
Sphygmomanometer
61) The nurse is caring for Kenneth experiencing an acute asthma attack. The client stops wheezing and breath sounds aren’t audible. The reason for this change is that:
The attack is over.
The airways are so swollen that no air cannot get through.
The swelling has decreased.
Crackles have replaced wheezes.
62) How can seasonal asthma come about?
Inhlation or exposure to trees, grasses or flowers releasing pollen into the air.
Inhalation of tobacco smoke
Exposure to paint thinners or dust
63) The key role of a physiotherapist in treatment of asthma is to …
Provide education to the patient about the disease and treatment options
Administering and educating the patient about airway clearance techniques
Provide education about exercise and the option of pulmonary rehabilitation classes
All of the above
None of the above
64) Asthma is….
Localised, irreversible dilation of part of the bronchial tree due to destruction of the muscle and elastic tissue
A persistent cough that produces sputum and mucus for at least 3 months of the year, two years in succession
A chronic inflammatory disorder of the airways associated with episodes of wheezing, breathlessness, chest tightness and coughing
Collapse and closure of alveoli resulting in reduced or absent gas exchange affecting all of part of the lung
65) Which of the following tests cannot detect airway inflammation?
Bronchial mucosal biopsy
Sputum eosinophil counts
Bronchoalveolar lavage
Spirometry
66) Asthma can be life-threatening.
True
False
67) Asthma causes the airways to:
Constrict
Become inflamed
Become lined with a large amount of mucus
All of the above
68) In an acute severe attack of asthma, it is important to get a chest x-ray done to rule out:
A pleural effusion
A pneumothorax
Lung malignancy
COPD
69) If a person suffers from asthma, what are the likely symptoms he/she may have?
Sore, swollen and sensitive airway linings.
Weak breathing
Fast and unsteady pulse
Cancer in the airway
70) An 8-year-old boy with asthma is brought to the clinic for check up. The mother asks the nurse if the treatment given to her son is effective. What would be the appropriate response of the nurse?
I will review first the child’s height on a growth chart to know if the treatment is working
I will review first the child’s weight on a growth chart to know if the treatment is working
I will review first the number of prescriptions refills the child has required over the last 6 months to give you an accurate answer
I will review first the number of times the child has seen the pediatrician during the last 6 months to give you an accurate answer
Answers and Rationales
B. Oral thrush
C. To use the medicines as prescribed
A. Children
D. Atropine
B. Epiglottitis. Acute and sever inflammation of the epiglottis can cause life threatening airway obstruction, that is why its always treated as a medical emergency. NSG intervention : Prepare tracheostomy set at bed side.LTB, can also cause airway obstruction but its not an emergency. Asthma is also not an emergency . CF is a chronic disease, so its not a medical emergency.
A. Salbutamol
A. Resonant sounds. When percussing the chest wall, the nurse expects to elicit resonant sounds — low-pitched, hollow sounds heard over normal lung tissue. Hyperresonant sounds indicate increased air in the lungs or pleural space; they’re louder and lower pitched than resonant sounds. Although hyperresonant sounds occur in such disorders as emphysema and pneumothorax, they may be normal in children and very thin adults. Dull sounds, normally heard only over the liver and heart, may occur over dense lung tissue, such as from consolidation or a tumor. Dull sounds are thudlike and of medium pitch. Flat sounds, soft and high-pitched, are heard over airless tissue and can be replicated by percussing the thigh or a bony structure.
C. Depressed immune system . Children who have a depressed immune system related to HIV or chemotherapy should not be given routine immunizations.
A. True
C. An atopic disease
A. True
D. A chronic respiratory disease
A. True
D. All of the above.
B. False
D. Bronchial hypotension
B. Give a bronchodilator by nebulizer. The patient having an acute asthma attack needs more oxygen delivered to his lungs and body. Nebulized bronchodilators open airways and increase the amount of oxygen delivered. The patient may not need cardiac monitoring because he’s only 19 years old, unless he has a medical history of cardiac problems.
D. B & C are correct
A. FEV1
B. Dyspnea
A. True . A significant correlation between nocturnal asthma and gastroesophageal reflux has been observed. The patient may not complain of epigastric burning or have reflux symptoms. Cough may be the only symptom.
B. False
C. “We’ll make sure he avoids exercise to prevent asthma attacks” Asthmatic children don’t have to avoid exercise. They can participate on physical activities as tolerated. Using a bronchodilator before administering steroids is correct because steroids are just anti-inflammatory and they don’t have effects on the dilation of the bronchioles. OF course letters A and B are obviously correct.
D. Pedal edema
A. True
A. True
C. Obesity. Obesity is a risk factor for CVA. Other risk factors include a history of ischemic episodes, cardiovascular disease, diabetes mellitus, atherosclerosis of the cranial vessels, hypertension, polycythemia, smoking, hypercholesterolemia, oral contraceptive use, emotional stress, family history of CVA, and advancing age. The client’s race, sex, and bronchial asthma aren’t risk factors for CVA.
A. True
A. tachycardia, nausea, vomiting, heart palpitations, inability to sleep, restlessness, and seizures. Bronchodilators can produce the side effects listed in answer choice for a short time after the patient begins using them.
D. Is a consequence of viral infection
D. Metracholine
C. The relationship of symptoms and a specific trigger such as physical exercise. COPD clients have low oxygen and high carbon dioxide levels. Therefore, hypoxia is the main stimulus for ventilation is persons with chronic hypercapnea. Increasing the level of oxygen would decrease the stimulus to breathe.
B. False . The acute cough and/or wheeze caused by a foreign body in the lower respiratory tract may diminish over time only to recur later and present as chronic cough and/or persistent wheezing.
E. Recurrent otitis media
B. Apple slices. Grapes is inappropriate because of its “skin” that can cause choking. A glass of milk is not a good snack because it’s the most common cause of Iron-deficiency anemia in children (milk contains few iron), A glass of cola is also not appropriate cause it contains complex sugar.
A. True
D. All of the above
B. A reliever is used to relieve asthma attacks.
A. True
B. Exposure to environmental tobacco smoke, breast feeding during infancy and allergen avoidance
A. Acute asthma . Based on the client’s history and symptoms, acute asthma is the most likely diagnosis. He’s unlikely to have bronchial pneumonia without a productive cough and fever and he’s too young to have developed (COPD) and emphysema.
B. Dynamic airway collapse
B. Bronchodilators . Bronchodilators are the first line of treatment for asthma because broncho-constriction is the cause of reduced airflow. Beta adrenergic blockers aren’t used to treat asthma and can cause bronchoconstriction. Inhaled oral steroids may be given to reduce the inflammation but aren’t used for emergency relief.
C. 2am-4am in the middle of the night
A. True . Try not to wear perfumes to school. Limit the use of scented aerosols in the center. Try to use non-aerosol cleaners while Asthmatic children are present.
B. False . Proteins in animal’s skin flakes, urine, feces, saliva and hair can trigger asthma. Dogs, cats, rodents (including hamsters and guinea pigs) and other warm-blooded mammals can trigger Asthma in individuals with an allergy to animal dander. SO, load your class with the Asthma friendliest pets of all-FISH!
B. False . Secondhand smoke can be present on your clothing therefore exposing children to it. Never smoke in clothing you wear to work.
D. Swelling of the bronchial mucosa, with wheezes starting on expiration and spreading to continuous. Bronchi normally expand and lengthen during inspiration and shorten during expiration. Asthma causes spasm of the smooth muscles in the bronchi and bronchioles, resulting in an even tighter airway on exhalation and prolonged exhalation. Inspirations increase in rate in an effort to relieve hypoxia. At the beginning of the attack, the cough is nonproductive and results from bronchial edema. Then the mucus becomes profuse and rattly, with a cough producing frothy, clear sputum. Gas trapping is the central feature of asthma. It is caused by allowing more air to enter alveoli than can escape from them through the narrowed airways. Gas trapping also causes an increased depth and rate of respirations. The wheeze starts during the expiratory phase because of the extreme narrowing of the bronchus on exhalation. As obstruction increases, wheezes become more high pitched and continuous.
C. Males aged 10-14 years & females aged 20-24 years
D. Bronchodilators and anti-inflammatory
A. True
D. All of the above
C. Moderate Persistent . Moderate persistent, great than one night per week of symptoms bumps him to Moderate persistent
D. History of steroid-dependent asthma . A history of steroid-dependent asthma, a contributing factor to this client’s high-risk status, requires the nurse to treat the situation as a severe exacerbation regardless of the severity of the current episode. An oxygen saturation of 95%, mild work of breathing, and absence of intercostals or substernal retractions are all normal findings.
B. Airway inflammation
D. All of the above is true
D. Spasm of bronchiolar smooth muscle. Asthma is the presence of bronchiolar spasms. This spasm can be brought on by allergies or anxiety. Answer A is incorrect because the primary physiological alteration is not inflammation. Answer B is incorrect because there is the production of abnormally viscous mucus, not a primary alteration. Answer C is incorrect because infection is not primary to asthma.
B. Mucous membranes. Skin color doesn’t affect the mucous membranes. The lips, nail beds, and earlobes are less reliable indicators of cyanosis because they’re affected by skin color.
A. Has increased airway obstruction . The higher pitched a sound is, the more narrow the airway. Therefore, the obstruction has increased or worsened. With no evidence of secretions no support exists to indicate the need for suctioning.
C. Peak flow meter
B. The airways are so swollen that no air cannot get through. During an acute attack, wheezing may stop and breath sounds become inaudible because the airways are so swollen that air can’t get through. If the attack is over and swelling has decreased, there would be no more wheezing and less emergent concern. Crackles do not replace wheezes during an acute asthma attack.
A. Inhlation or exposure to trees, grasses or flowers releasing pollen into the air.
D. All of the above
C. A chronic inflammatory disorder of the airways associated with episodes of wheezing, breathlessness, chest tightness and coughing
D. Spirometry
A. True
D. All of the above
B. A pneunothorax
A. Sore, swollen and sensitive airway linings.
C. I will review first the number of prescriptions refills the child has required over the last 6 months to give you an accurate answer. Reviewing the number of prescription refills the child has required over the last 6 months would be the best indicator of how well controlled and thus how effective the child’s asthma treatment is. Breakthrough wheezing, shortness of breath, and upper respiratory infections would require that the child take additional medication. This would be reflected in the number of prescription refills.