MSN Exam for Bronchitis (Acute & Chronic)

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1) What are some of the initial symptoms of bronchitis?

  1. Shortness of breath worsened by exertion or mild activity
  2. Fatigue, fever with chills and chest discomfort
  3. Cough that produces mucus
  4. All of the above

2) What are the additional symptoms of chronic bronchitis?

  1. Frequent respiratory infections (such as colds or the flu)
  2. Ankle, feet, and leg swelling
  3. Blue-tinged lips from low levels of oxygen
  4. All of the above

3) Which of the following statements are true about acute bronchitis?

  1. Acute bronchitis generally follows a viral respiratory infection
  2. Smokers and people with heart or lung disease at a higher risk of contracting the disease
  3. It affects nose, sinuses, and throat and then spreads to the lungs
  4. All of the above

4) A 67-year-old client develops acute shortness of breath and progressive hypoxia requiring right femur. The hypoxia was probably caused by which of the following conditions?

  1. Asthma attack
  2. Atelectasis
  3. Bronchitis
  4. Fat embolism

5) The term “pink puffer” refers to the female client with which of the following conditions?

  1. Adult respiratory distress syndrome (ARDS)
  2. Asthma
  3. Chronic obstructive bronchitis
  4. Emphysema

6) A 62-year-old male client was in a motor vehicle accident as an unrestrained driver. He’s now in the emergency department complaining of difficulty of breathing and chest pain. On auscultation of his lung field, no breath sounds are present in the upper lobe. This client may have which of the following conditions?

  1. Bronchitis
  2. Pneumonia
  3. Pneumothorax
  4. Tuberculosis (TB)

7) The nurse is teaching a male client with chronic bronchitis about breathing exercises. Which of the following should the nurse include in the teaching?

  1. Make inhalation longer than exhalation.
  2. Exhale through an open mouth.
  3. Use diaphragmatic breathing.
  4. Use chest breathing.

8) A client with acute bronchitis is admitted in the hospital. The nurse assigned to the client is making a plan of care regarding expectoration of thick sputum. Which nursing action is most effective?

  1. Place the client in a lateral position every 2 hour
  2. Splint the patient’s chest with pillows when coughing
  3. Use humified oxygen
  4. Offer fluids at regular intervals

9) The term “blue bloater” refers to a male client which of the following conditions?

  1. Adult respiratory distress syndrome (ARDS)
  2. Asthma
  3. Chronic obstructive bronchitis
  4. Emphysema

10) Johnny a firefighter was involved in extinguishing a house fire and is being treated to smoke inhalation. He develops severe hypoxia 48 hours after the incident, requiring intubation and mechanical ventilation. He most likely has developed which of the following conditions?

  1. Adult respiratory distress syndrome (ARDS)
  2. Atelectasis
  3. Bronchitis
  4. Pneumonia

11) It is unusual to have a dry, nagging cough that lingers for several weeks even after acute bronchitis has cleared.

  1. True
  2. False

12) Which of the following statements describe cough that is the most common symptom of bronchitis?

  1. The cough may be dry or may produce phlegm
  2. The cough may hang on more than 2 weeks
  3. Cough can be severe enough at times to injure the chest wall
  4. All of the above

13) A client with shortness of breath has decreased to absent breath sounds on the right side, from the apex to the base. Which of the following conditions would best explain this?

  1. Acute asthma
  2. Chronic bronchitis
  3. Pneumonia
  4. Spontaneous pneumothorax

14) The nurse in charge formulates a nursing diagnosis of Activity intolerance related to inadequate oxygenation and dyspnea for a client with chronic bronchitis. To minimize this problem, the nurse instructs the client to avoid conditions that increase oxygen demands. Such conditions include:

  1. Drinking more than 1,500 ml of fluid daily.
  2. Being overweight.
  3. Eating a high-protein snack at bedtime.
  4. Eating more than three large meals a day.

15) The nurse is caring for an 80-year-old with chronic bronchitis. Upon the morning rounds, the nurse finds an O2 sat of 76%. Which of the following actions should the nurse take first?

  1. Notify the physician
  2. Recheck the O2 saturation level in 15 minutes
  3. Apply oxygen by mask
  4. Assess the child’s pulse

16) Continued forceful coughing may cause chest and abdominal muscles to ache.

  1. True
  2. False

17) Cigarette smoking is the main cause of chronic bronchitis

  1. True
  2. False

18) Nurse Eve formulates a nursing diagnosis of Activity intolerance related to inadequate oxygenation and dyspnea for a client with chronic bronchitis. To minimize this problem, the nurse instructs the client to avoid conditions that increase oxygen demands. Such conditions include:

  1. drinking more than 1,500 ml of fluid daily.
  2. being overweight.
  3. eating a high-protein snack at bedtime.
  4. eating more than three large meals a day.

19) Which is the most common symptom of bronchitis?

  1. Shortness of breath worsened by exertion or mild activity
  2. Wheezing, fatigue, fever and chest discomfort
  3. Cough
  4. All of the above

20) Which of the following statements are true about chronic bronchitis?

  1. Chronic bronchitis is a long-term condition
  2. Cigarette smoke, including long-term exposure to second-hand smoke, is the main cause of chronic bronchitis
  3. It requires regular medical treatment
  4. All of the above
Answers and Rationales
  1. D. All of the above
  2. D. All of the above
  3. D. All of the above
  4. D. Fat embolism. Long bone fractures are correlated with fat emboli, whichcause shortness of breath and hypoxia. It’s unlikely the client has developed asthma or bronchitis without a previous history. He could develop atelectasis but it typically doesn’t produce progressive hypoxia.
  5. D. Emphysema. Because of the large amount of energy it takes to breathe, clients with emphysema are usually cachectic. They’re pink and usually breathe through pursed lips, hence the term “puffer.” Clients with ARDS are usually acutely short of breath. Clients with asthma don’t have any particular characteristics, and clients with chronic obstructive bronchitis are bloated and cyanotic in appearance.
  6. C. Pneumothorax . From the trauma the client experienced, it’s unlikely he has bronchitis, pneumonia, or TB; rhonchi with bronchitis, bronchial breath sounds with TB would be heard.
  7. C. Use diaphragmatic breathing. In chronic bronchitis the diaphragm is flat and weak. Diaphragmatic breathing helps to strengthen the diaphragm and maximizes ventilation. Exhalation should be longer than inhalation to prevent collapse of the bronchioles. The client with chronic bronchitis should exhale through pursed lips to prolong exhalation, keep the bronchioles from collapsing, and prevent air trapping. Diaphragmatic breathing — not chest breathing — increases lung expansion.
  8. D. Offer fluids at regular intervals. Fluids liquefy secretions and therefore make it easier to expectorate
  9. C. Chronic obstructive bronchitis. Clients with chronic obstructive bronchitis appear bloated; they have large barrel chest and peripheral edema, cyanotic nail beds, and at times, circumoral cyanosis. Clients with ARDS are acutely short of breath and frequently need intubation for mechanical ventilation and large amount of oxygen. Clients with asthma don’t exhibit characteristics of chronic disease, and clients with emphysema appear pink and cachectic.
  10. A. Adult respiratory distress syndrome (ARDS). Severe hypoxia after smoke inhalation is typically related to ARDS. The other conditions listed aren’t typically associated with smoke inhalation and severe hypoxia.
  11. B. False
  12. D. All of the above
  13. D. Spontaneous pneumothorax. A spontaneous pneumothorax occurs when the client’s lung collapses, causing an acute decreased in the amount of functional lung used in oxygenation. The sudden collapse was the cause of his chest pain and shortness of breath. An asthma attack would show wheezing breath sounds, and bronchitis would have rhonchi. Pneumonia would have bronchial breath sounds over the area of consolidation.
  14. B. Being overweight. Conditions that increase oxygen demands include obesity, smoking, exposure to temperature extremes, and stress. A client with chronic bronchitis should drink at least 2,000 ml of fluid daily to thin mucus secretions; restricting fluid intake may be harmful. The nurse should encourage the client to eat a high-protein snack at bedtime because protein digestion produces an amino acid with sedating effects that may ease the insomnia associated with chronic bronchitis. Eating more than three large meals a day may cause fullness, making breathing uncomfortable and difficult; however, it doesn’t increase oxygen demands. To help maintain adequate nutritional intake, the client with chronic bronchitis should eat small, frequent meals (up to six a day).
  15. C. Apply oxygen by mask. Remember the ABCs (airway, breathing, circulation) when answering this question. Before notifying the physician or assessing the pulse, oxygen should be applied to increase the oxygen saturation. The normal oxygen saturation for a child is 92%–100%.
  16. A. True
  17. A. True
  18. B. being overweight. Conditions that increase oxygen demands include obesity, smoking, exposure to temperature extremes, and stress. A client with chronic bronchitis should drink at least 2,000 ml of fluid daily to thin mucus secretions; restricting fluid intake may be harmful. The nurse should encourage the client to eat a high-protein snack at bedtime because protein digestion produces an amino acid with sedating effects that may ease the insomnia associated with chronic bronchitis. Eating more than three large meals a day may cause fullness, making breathing uncomfortable and difficult; however, it doesn’t increase oxygen demands. To help maintain adequate nutritional intake, the client with chronic bronchitis should eat small, frequent meals (up to six a day).
  19. C. Cough 
  20. D. All of the above 

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