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MSN Exam for Emphysema (PM)
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Question 1
Of the following oxygen administration devices, which has the advantage of providing high oxygen concentration?
A
Non-rebreather mask
B
Face tent
C
Venturi mask
D
Catheter
Question 1 Explanation:
The non-rebreather mask provides high oxygen concentration but is usually poor fitting. The Venturi mask provides low levels of supplemental oxygen. The catheter is an inexpensive device that provides a variable fraction of inspired oxygen and may cause gastric distention. A face tent provides a fairly accurate fraction of inspired oxygen, but is bulky and uncomfortable. It would not be the device of choice to provide high oxygen concentration.
Question 2
A nurse is assessing a male client with chronic airflow limitations and notes that the client has a “barrel chest.” The nurse interprets that this client has which of the following forms of chronic airflow limitations?
A
Bronchial asthma and bronchitis
B
Chronic obstructive bronchitis
C
Bronchial asthma
D
Emphysema
Question 2 Explanation:
The client with emphysema has hyperinflation of the alveoli and flattening of the diaphragm. These lead to increased anteroposterior diameter, referred to as “barrel chest.” The client also has dyspnea with prolonged expiration and has hyperresonant lungs to percussion.
Question 3
Mr. Vasquez 56-year-old client with a 40-year history of smoking one to two packs of cigarettes per day has a chronic cough producing thick sputum, peripheral edema and cyanotic nail beds. Based on this information, he most likely has which of the following conditions?
A
Asthma
B
Emphysema
C
Adult respiratory distress syndrome (ARDS)
D
Chronic obstructive bronchitis
Question 3 Explanation:
Because of this extensive smoking history and symptoms the client most likely has chronic obstructive bronchitis. Client with ARDS have acute symptoms of hypoxia and typically need large amounts of oxygen. Clients with asthma and emphysema tend not to have chronic cough or peripheral edema.
Question 4
A person with emphysema will not exhibit noticeable symptoms.
A
False
B
True
Question 4 Explanation:
They will exhibit symptoms including chronic cough, loss of appetite, fatigue, shortness of breath, excessive mucous production, wheezing, and blue tinting of the skin.
Incorrect
Question 5
A nurse is caring for a male client with emphysema who is receiving oxygen. The nurse assesses the oxygen flow rate to ensure that it does not exceed:
A
6 L/min
B
10 L/min
C
1 L/min
D
2 L/min
Question 5 Explanation:
Oxygen is used cautiously and should not exceed 2 L/min. Because of the long-standing hypercapnia that occurs in emphysema, the respiratory drive is triggered by low oxygen levels rather than increased carbon dioxide levels, as is the case in a normal respiratory system.
Question 6
A male client with emphysema becomes restless and confused. What step should nurse Jasmine take next?
A
Increase the client’s oxygen flow rate.
B
Check the client’s temperature.
C
Assess the client’s potassium level.
D
Encourage the client to perform pursed lip breathing.
Question 6 Explanation:
Purse lip breathing prevents the collapse of lung unit and helps client control rate and depth of breathing.
Question 7
A lung transplant is the only way to slow the progression of emphysema.
A
False
B
True
Question 7 Explanation:
Smoking cessation, pulmonary rehabilitation, adopting a healthy lifestyle, and prescription drug therapy are all ways to slow the progression of emphysema.
Incorrect
Question 8
The inhalation of environmental air pollutants in the #1 cause of emphysema cases.
A
False
B
True
Question 8 Explanation:
Smoking is the #1 cause of emphysema
Question 9
Emphysema is described as:
A
The presence of cough and sputum production for at least a combined total of two or three months in each of two consecutive years.
B
A disease of the airways characterized by destruction of the walls of overdistended alveoli.
C
A disease that results in a common clinical outcome of reversible airflow obstruction.
D
Chronic dilatation of a bronchus or bronchi
Question 9 Explanation:
Emphysema is a category of COPD.
Question 10
Which of the following is the most important risk factor for development of Chronic Obstructive Pulmonary Disease?
A
Occupational exposure
B
Genetic abnormalities
C
Cigarette smoking
D
Air pollution
Question 10 Explanation:
Pipe, cigar and other types of tobacco smoking are also risk factors. While a risk factor, occupational exposure is not the most important risk factor for development of COPD. Air pollution is a risk factor for development of COPD, but it is not the most important risk factor. A deficiency of alpha-antitrypsin is a risk factor for development of COPD, but it is not the most important risk factor.
Question 11
Which of the following actions is most appropriate for the nurse to take when the patient demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery?
A
Apply a compression dressing to the area.
B
Measure the patient’s pulse oximetry.
C
Record the observation.
D
Report the finding to the physician immediately.
Question 11 Explanation:
Subcutaneous emphysema occurs after chest surgery as the air that is located within the pleural cavity is expelled through the tissue opening created by the surgical procedure.
Question 12
Nurse Murphy administers albuterol (Proventil), as prescribed, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect?
A
Dilated and reactive pupils
B
Heart rate of 100 beats/minute
C
Respiratory rate of 22 breaths/minute
D
Urine output of 40 ml/hour
Question 12 Explanation:
In a client with emphysema, albuterol is used as a bronchodilator. A respiratory rate of 22 breaths/minute indicates that the drug has achieved its therapeutic effect because fewer respirations are required to achieve oxygenation. Albuterol has no effect on pupil reaction or urine output. It may cause a change in the heart rate, but this is an adverse, not therapeutic, effect.
Question 13
Which of the following types of lung cancer is the most prevalent carcinoma of the lung for both men and women?
A
Adenocarcinoma
B
Squamous cell carcinoma
C
Small cell carcinoma
D
Large cell carcinoma
Question 13 Explanation:
Adenocarcinoma presents more peripherally as peripheral masses or nodules and often metastasizes.
Question 14
Carbon monoxide is the waste product expelled from the body when you breathe out.
A
False
B
True
Question 14 Explanation:
Carbon dioxide is the waste product, not carbon monoxide
Question 15
The nurse in charge is teaching a client with emphysema how to perform pursed-lip breathing. The client asks the nurse to explain the purpose of this breathing technique. Which explanation should the nurse provide?
A
It decreases use of accessory breathing muscles.
B
It prolongs the inspiratory phase of respiration.
C
It increases inspiratory muscle strength.
D
It helps prevent early airway collapse.
Question 15 Explanation:
Pursed-lip breathing helps prevent early airway collapse. Learning this technique helps the client control respiration during periods of excitement, anxiety, exercise, and respiratory distress. To increase inspiratory muscle strength and endurance, the client may need to learn inspiratory resistive breathing. To decrease accessory muscle use and thus reduce the work of breathing, the client may need to learn diaphragmatic (abdominal) breathing. In pursed-lip breathing, the client mimics a normal inspiratory-expiratory (I:E) ratio of 1:2. (A client with emphysema may have an I:E ratio as high as 1:4.)
Question 16
Air flows through the trachea into the left and right bronchi upon inspiration.
A
False
B
True
Question 17
Emphysema is not linked to which of the following terms?
A
Blue Bloater
B
Tachycardia
C
Dyspnea
D
Liver cirrhosis
Question 18
Once diagnosed with emphysema, the disease state is constant.
A
False
B
True
Question 18 Explanation:
The disease state is progressive. Even though it cannot be stopped it can be slowed with treatment.
Question 19
Emphysema can be cured.
A
False
B
True
Question 19 Explanation:
There is no cure but the symptoms can be treated and progression of the disease can be slowed.
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MSN Exam for Emphysema (EM)
Choose the letter of the correct answer. You got 19 minutes to finish the exam .Good luck!
Start
Congratulations - you have completed MSN Exam for Emphysema (EM).
You scored %%SCORE%% out of %%TOTAL%%.
Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
Emphysema is described as:
A
Chronic dilatation of a bronchus or bronchi
B
A disease that results in a common clinical outcome of reversible airflow obstruction.
C
The presence of cough and sputum production for at least a combined total of two or three months in each of two consecutive years.
D
A disease of the airways characterized by destruction of the walls of overdistended alveoli.
Question 1 Explanation:
Emphysema is a category of COPD.
Question 2
Of the following oxygen administration devices, which has the advantage of providing high oxygen concentration?
A
Catheter
B
Non-rebreather mask
C
Venturi mask
D
Face tent
Question 2 Explanation:
The non-rebreather mask provides high oxygen concentration but is usually poor fitting. The Venturi mask provides low levels of supplemental oxygen. The catheter is an inexpensive device that provides a variable fraction of inspired oxygen and may cause gastric distention. A face tent provides a fairly accurate fraction of inspired oxygen, but is bulky and uncomfortable. It would not be the device of choice to provide high oxygen concentration.
Question 3
A nurse is assessing a male client with chronic airflow limitations and notes that the client has a “barrel chest.” The nurse interprets that this client has which of the following forms of chronic airflow limitations?
A
Chronic obstructive bronchitis
B
Bronchial asthma
C
Bronchial asthma and bronchitis
D
Emphysema
Question 3 Explanation:
The client with emphysema has hyperinflation of the alveoli and flattening of the diaphragm. These lead to increased anteroposterior diameter, referred to as “barrel chest.” The client also has dyspnea with prolonged expiration and has hyperresonant lungs to percussion.
Question 4
Which of the following is the most important risk factor for development of Chronic Obstructive Pulmonary Disease?
A
Air pollution
B
Genetic abnormalities
C
Occupational exposure
D
Cigarette smoking
Question 4 Explanation:
Pipe, cigar and other types of tobacco smoking are also risk factors. While a risk factor, occupational exposure is not the most important risk factor for development of COPD. Air pollution is a risk factor for development of COPD, but it is not the most important risk factor. A deficiency of alpha-antitrypsin is a risk factor for development of COPD, but it is not the most important risk factor.
Question 5
Carbon monoxide is the waste product expelled from the body when you breathe out.
A
False
B
True
Question 5 Explanation:
Carbon dioxide is the waste product, not carbon monoxide
Question 6
A male client with emphysema becomes restless and confused. What step should nurse Jasmine take next?
A
Check the client’s temperature.
B
Increase the client’s oxygen flow rate.
C
Assess the client’s potassium level.
D
Encourage the client to perform pursed lip breathing.
Question 6 Explanation:
Purse lip breathing prevents the collapse of lung unit and helps client control rate and depth of breathing.
Question 7
Which of the following actions is most appropriate for the nurse to take when the patient demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery?
A
Apply a compression dressing to the area.
B
Measure the patient’s pulse oximetry.
C
Record the observation.
D
Report the finding to the physician immediately.
Question 7 Explanation:
Subcutaneous emphysema occurs after chest surgery as the air that is located within the pleural cavity is expelled through the tissue opening created by the surgical procedure.
Question 8
The inhalation of environmental air pollutants in the #1 cause of emphysema cases.
A
True
B
False
Question 8 Explanation:
Smoking is the #1 cause of emphysema
Question 9
Which of the following types of lung cancer is the most prevalent carcinoma of the lung for both men and women?
A
Adenocarcinoma
B
Large cell carcinoma
C
Squamous cell carcinoma
D
Small cell carcinoma
Question 9 Explanation:
Adenocarcinoma presents more peripherally as peripheral masses or nodules and often metastasizes.
Question 10
Once diagnosed with emphysema, the disease state is constant.
A
True
B
False
Question 10 Explanation:
The disease state is progressive. Even though it cannot be stopped it can be slowed with treatment.
Question 11
Air flows through the trachea into the left and right bronchi upon inspiration.
A
False
B
True
Question 12
A person with emphysema will not exhibit noticeable symptoms.
A
True
B
False
Question 12 Explanation:
They will exhibit symptoms including chronic cough, loss of appetite, fatigue, shortness of breath, excessive mucous production, wheezing, and blue tinting of the skin.
Incorrect
Question 13
Emphysema can be cured.
A
False
B
True
Question 13 Explanation:
There is no cure but the symptoms can be treated and progression of the disease can be slowed.
Question 14
The nurse in charge is teaching a client with emphysema how to perform pursed-lip breathing. The client asks the nurse to explain the purpose of this breathing technique. Which explanation should the nurse provide?
A
It prolongs the inspiratory phase of respiration.
B
It increases inspiratory muscle strength.
C
It decreases use of accessory breathing muscles.
D
It helps prevent early airway collapse.
Question 14 Explanation:
Pursed-lip breathing helps prevent early airway collapse. Learning this technique helps the client control respiration during periods of excitement, anxiety, exercise, and respiratory distress. To increase inspiratory muscle strength and endurance, the client may need to learn inspiratory resistive breathing. To decrease accessory muscle use and thus reduce the work of breathing, the client may need to learn diaphragmatic (abdominal) breathing. In pursed-lip breathing, the client mimics a normal inspiratory-expiratory (I:E) ratio of 1:2. (A client with emphysema may have an I:E ratio as high as 1:4.)
Question 15
Nurse Murphy administers albuterol (Proventil), as prescribed, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect?
A
Dilated and reactive pupils
B
Respiratory rate of 22 breaths/minute
C
Urine output of 40 ml/hour
D
Heart rate of 100 beats/minute
Question 15 Explanation:
In a client with emphysema, albuterol is used as a bronchodilator. A respiratory rate of 22 breaths/minute indicates that the drug has achieved its therapeutic effect because fewer respirations are required to achieve oxygenation. Albuterol has no effect on pupil reaction or urine output. It may cause a change in the heart rate, but this is an adverse, not therapeutic, effect.
Question 16
Emphysema is not linked to which of the following terms?
A
Dyspnea
B
Blue Bloater
C
Liver cirrhosis
D
Tachycardia
Question 17
A lung transplant is the only way to slow the progression of emphysema.
A
False
B
True
Question 17 Explanation:
Smoking cessation, pulmonary rehabilitation, adopting a healthy lifestyle, and prescription drug therapy are all ways to slow the progression of emphysema.
Incorrect
Question 18
A nurse is caring for a male client with emphysema who is receiving oxygen. The nurse assesses the oxygen flow rate to ensure that it does not exceed:
A
6 L/min
B
2 L/min
C
10 L/min
D
1 L/min
Question 18 Explanation:
Oxygen is used cautiously and should not exceed 2 L/min. Because of the long-standing hypercapnia that occurs in emphysema, the respiratory drive is triggered by low oxygen levels rather than increased carbon dioxide levels, as is the case in a normal respiratory system.
Question 19
Mr. Vasquez 56-year-old client with a 40-year history of smoking one to two packs of cigarettes per day has a chronic cough producing thick sputum, peripheral edema and cyanotic nail beds. Based on this information, he most likely has which of the following conditions?
A
Asthma
B
Adult respiratory distress syndrome (ARDS)
C
Emphysema
D
Chronic obstructive bronchitis
Question 19 Explanation:
Because of this extensive smoking history and symptoms the client most likely has chronic obstructive bronchitis. Client with ARDS have acute symptoms of hypoxia and typically need large amounts of oxygen. Clients with asthma and emphysema tend not to have chronic cough or peripheral edema.
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Q.1) Carbon monoxide is the waste product expelled from the body when you breathe out.
True
False
Q.2) Of the following oxygen administration devices, which has the advantage of providing high oxygen concentration?
Non-rebreather mask
Venturi mask
Catheter
Face tent
Q.3) A male client with emphysema becomes restless and confused. What step should nurse Jasmine take next?
Encourage the client to perform pursed lip breathing.
Check the client’s temperature.
Assess the client’s potassium level.
Increase the client’s oxygen flow rate.
Q.4) Which of the following is the most important risk factor for development of Chronic Obstructive Pulmonary Disease?
Cigarette smoking
Occupational exposure
Air pollution
Genetic abnormalities
Q.5) A nurse is caring for a male client with emphysema who is receiving oxygen. The nurse assesses the oxygen flow rate to ensure that it does not exceed:
1 L/min
2 L/min
6 L/min
10 L/min
Q.6) Mr. Vasquez 56-year-old client with a 40-year history of smoking one to two packs of cigarettes per day has a chronic cough producing thick sputum, peripheral edema and cyanotic nail beds. Based on this information, he most likely has which of the following conditions?
Adult respiratory distress syndrome (ARDS)
Asthma
Chronic obstructive bronchitis
Emphysema
Q.7) The nurse in charge is teaching a client with emphysema how to perform pursed-lip breathing. The client asks the nurse to explain the purpose of this breathing technique. Which explanation should the nurse provide?
It helps prevent early airway collapse.
It increases inspiratory muscle strength.
It decreases use of accessory breathing muscles.
It prolongs the inspiratory phase of respiration.
Q.8) Emphysema can be cured.
True
False
Q.9) Emphysema is described as:
A disease of the airways characterized by destruction of the walls of overdistended alveoli.
A disease that results in a common clinical outcome of reversible airflow obstruction.
The presence of cough and sputum production for at least a combined total of two or three months in each of two consecutive years.
Chronic dilatation of a bronchus or bronchi
Q.10) Emphysema is not linked to which of the following terms?
Blue Bloater
Dyspnea
Liver cirrhosis
Tachycardia
Q.11) Which of the following actions is most appropriate for the nurse to take when the patient demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery?
Record the observation.
Apply a compression dressing to the area.
Measure the patient’s pulse oximetry.
Report the finding to the physician immediately.
Q.12) A person with emphysema will not exhibit noticeable symptoms.
True
False
Q.13) Nurse Murphy administers albuterol (Proventil), as prescribed, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect?
Respiratory rate of 22 breaths/minute
Dilated and reactive pupils
Urine output of 40 ml/hour
Heart rate of 100 beats/minute
Q.14) The inhalation of environmental air pollutants in the #1 cause of emphysema cases.
True
False
Q.15) Air flows through the trachea into the left and right bronchi upon inspiration.
True
False
Q.16) Once diagnosed with emphysema, the disease state is constant.
True
False
Q.17) A nurse is assessing a male client with chronic airflow limitations and notes that the client has a “barrel chest.” The nurse interprets that this client has which of the following forms of chronic airflow limitations?
Emphysema
Bronchial asthma
Chronic obstructive bronchitis
Bronchial asthma and bronchitis
Q.18) A lung transplant is the only way to slow the progression of emphysema.
True
False
Q.19) Which of the following types of lung cancer is the most prevalent carcinoma of the lung for both men and women?
Adenocarcinoma
Large cell carcinoma
Squamous cell carcinoma
Small cell carcinoma
Answers and Rationales
B. False . Carbon dioxide is the waste product, not carbon monoxide
A. Non-rebreather mask. The non-rebreather mask provides high oxygen concentration but is usually poor fitting. The Venturi mask provides low levels of supplemental oxygen. The catheter is an inexpensive device that provides a variable fraction of inspired oxygen and may cause gastric distention. A face tent provides a fairly accurate fraction of inspired oxygen, but is bulky and uncomfortable. It would not be the device of choice to provide high oxygen concentration.
A. Encourage the client to perform pursed lip breathing. Purse lip breathing prevents the collapse of lung unit and helps client control rate and depth of breathing.
A. Cigarette smoking . Pipe, cigar and other types of tobacco smoking are also risk factors. While a risk factor, occupational exposure is not the most important risk factor for development of COPD. Air pollution is a risk factor for development of COPD, but it is not the most important risk factor. A deficiency of alpha-antitrypsin is a risk factor for development of COPD, but it is not the most important risk factor.
B. 2 L/min . Oxygen is used cautiously and should not exceed 2 L/min. Because of the long-standing hypercapnia that occurs in emphysema, the respiratory drive is triggered by low oxygen levels rather than increased carbon dioxide levels, as is the case in a normal respiratory system.
C. Chronic obstructive bronchitis . Because of this extensive smoking history and symptoms the client most likely has chronic obstructive bronchitis. Client with ARDS have acute symptoms of hypoxia and typically need large amounts of oxygen. Clients with asthma and emphysema tend not to have chronic cough or peripheral edema.
A. It helps prevent early airway collapse. Pursed-lip breathing helps prevent early airway collapse. Learning this technique helps the client control respiration during periods of excitement, anxiety, exercise, and respiratory distress. To increase inspiratory muscle strength and endurance, the client may need to learn inspiratory resistive breathing. To decrease accessory muscle use and thus reduce the work of breathing, the client may need to learn diaphragmatic (abdominal) breathing. In pursed-lip breathing, the client mimics a normal inspiratory-expiratory (I:E) ratio of 1:2. (A client with emphysema may have an I:E ratio as high as 1:4.)
B. False . There is no cure but the symptoms can be treated and progression of the disease can be slowed.
A. A disease of the airways characterized by destruction of the walls of overdistended alveoli. Emphysema is a category of COPD.
A. Blue Bloater
A. Record the observation.Subcutaneous emphysema occurs after chest surgery as the air that is located within the pleural cavity is expelled through the tissue opening created by the surgical procedure.
B. False. They will exhibit symptoms including chronic cough, loss of appetite, fatigue, shortness of breath, excessive mucous production, wheezing, and blue tinting of the skin.
A. Respiratory rate of 22 breaths/minute. In a client with emphysema, albuterol is used as a bronchodilator. A respiratory rate of 22 breaths/minute indicates that the drug has achieved its therapeutic effect because fewer respirations are required to achieve oxygenation. Albuterol has no effect on pupil reaction or urine output. It may cause a change in the heart rate, but this is an adverse, not therapeutic, effect.
B. False . Smoking is the #1 cause of emphysema
A. True
B. False. The disease state is progressive. Even though it cannot be stopped it can be slowed with treatment.
A. Emphysema . The client with emphysema has hyperinflation of the alveoli and flattening of the diaphragm. These lead to increased anteroposterior diameter, referred to as “barrel chest.” The client also has dyspnea with prolonged expiration and has hyperresonant lungs to percussion.
B. False. Smoking cessation, pulmonary rehabilitation, adopting a healthy lifestyle, and prescription drug therapy are all ways to slow the progression of emphysema.
A. Adenocarcinoma . Adenocarcinoma presents more peripherally as peripheral masses or nodules and often metastasizes.