MSN Exam for Emphysema

Q.1) Carbon monoxide is the waste product expelled from the body when you breathe out.

  1. True
  2. False

Q.2) Of the following oxygen administration devices, which has the advantage of providing high oxygen concentration?

  1. Non-rebreather mask
  2. Venturi mask
  3. Catheter
  4. Face tent

Q.3) A male client with emphysema becomes restless and confused. What step should nurse Jasmine take next?

  1. Encourage the client to perform pursed lip breathing.
  2. Check the client’s temperature.
  3. Assess the client’s potassium level.
  4. 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?

  1. Cigarette smoking
  2. Occupational exposure
  3. Air pollution
  4. 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. 1 L/min
  2. 2 L/min
  3. 6 L/min
  4. 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?

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

  1. It helps prevent early airway collapse.
  2. It increases inspiratory muscle strength.
  3. It decreases use of accessory breathing muscles.
  4. It prolongs the inspiratory phase of respiration.

Q.8) Emphysema can be cured.

  1. True
  2. False

Q.9) Emphysema is described as:

  1. A disease of the airways characterized by destruction of the walls of overdistended alveoli.
  2. A disease that results in a common clinical outcome of reversible airflow obstruction.
  3. The presence of cough and sputum production for at least a combined total of two or three months in each of two consecutive years.
  4. Chronic dilatation of a bronchus or bronchi

Q.10) Emphysema is not linked to which of the following terms?

  1. Blue Bloater
  2. Dyspnea
  3. Liver cirrhosis
  4. 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?

  1. Record the observation.
  2. Apply a compression dressing to the area.
  3. Measure the patient’s pulse oximetry.
  4. Report the finding to the physician immediately.

Q.12) A person with emphysema will not exhibit noticeable symptoms.

  1. True
  2. 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?

  1. Respiratory rate of 22 breaths/minute
  2. Dilated and reactive pupils
  3. Urine output of 40 ml/hour
  4. Heart rate of 100 beats/minute

Q.14) The inhalation of environmental air pollutants in the #1 cause of emphysema cases.

  1. True
  2. False

Q.15) Air flows through the trachea into the left and right bronchi upon inspiration.

  1. True
  2. False

Q.16) Once diagnosed with emphysema, the disease state is constant.

  1. True
  2. 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?

  1. Emphysema
  2. Bronchial asthma
  3. Chronic obstructive bronchitis
  4. Bronchial asthma and bronchitis

Q.18) A lung transplant is the only way to slow the progression of emphysema.

  1. True
  2. False

Q.19) Which of the following types of lung cancer is the most prevalent carcinoma of the lung for both men and women?

  1. Adenocarcinoma
  2. Large cell carcinoma
  3. Squamous cell carcinoma
  4. Small cell carcinoma
Answers and Rationales
  1. B. False . Carbon dioxide is the waste product, not carbon monoxide
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.)
  8. B. False . There is no cure but the symptoms can be treated and progression of the disease can be slowed.
  9. A. A disease of the airways characterized by destruction of the walls of overdistended alveoli. Emphysema is a category of COPD.
  10. A. Blue Bloater 
  11. 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.
  12. 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.
  13. 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.
  14. B. False . Smoking is the #1 cause of emphysema
  15. A. True
  16. B. False. The disease state is progressive. Even though it cannot be stopped it can be slowed with treatment.
  17. 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.
  18. B. False. Smoking cessation, pulmonary rehabilitation, adopting a healthy lifestyle, and prescription drug therapy are all ways to slow the progression of emphysema.
  19. A. Adenocarcinoma . Adenocarcinoma presents more peripherally as peripheral masses or nodules and often metastasizes.