NCLEX Questions about Airway – Obstruction and Asthma

1. An elderly client with pneumonia may appear with which of the following symptoms first?

a. Altered mental status and dehydration
b. fever and chills
c. Hemoptysis and dyspnea
d. Pleuretic chest pain and cough

2. Which of the following pathophysiological mechanisms that occurs in the lung parenchyma allows pneumonia to develop?

a. Atelectasis
b. Bronchiectasis
c. Effusion
d. Inflammation

3. A 7-year-old client is brought to the E.R. He’s tachypneic and afebrile and has a respiratory rate of 36 breaths/minute and a nonproductive cough. He recently had a cold. From his history, the client may have which of the following?

a. Acute asthma
b. Bronchial pneumonia
c. Chronic obstructive pulmonary disease (COPD)
d. Emphysema

4. Which of the following assessment findings would help confirm a diagnosis of asthma in a client suspected of having the disorder?

a. Circumoral cyanosis
b. Increased forced expiratory volume
c. Inspiratory and expiratory wheezing
d. Normal breath sounds

5. Which of the following types of asthma involves an acute asthma attack brought on by an upper respiratory infection?

a. Emotional
b. Extrinsic
c. Intrinsic
d. Mediated

6. A client with acute asthma showing inspiratory and expiratory wheezes and a decreased 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

7. A 19-year-old comes into the emergency department 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 be taken first?

a. Take a full medication history
b. Give a bronchodilator by neubulizer
c. Apply a cardiac monitor to the client
d. Provide emotional support to the client.

8. A 58-year-old client with a 40-year history of smoking one to two packs of cigarettes a 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. Adult respiratory distress syndrome (ARDS)
b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema

9. The term “blue bloater” refers to which of the following conditions?

a. Adult respiratory distress syndrome (ARDS)
b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema

10. The term “pink puffer” refers to the client with which of the following conditions?

b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema

11. A 66-year-old client has marked dyspnea at rest, is thin, and uses accessory muscles to breathe. He’s tachypneic, with a prolonged expiratory phase. He has no cough. He leans forward with his arms braced on his knees to support his chest and shoulders for breathing. This client has symptoms of which of the following respiratory disorders?

b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema

12. It’s highly recommended that clients with asthma, chronic bronchitis, and emphysema have Pneumovax and flu vaccinations for which of the following reasons?

a. All clients are recommended to have these vaccines
b. These vaccines produce bronchodilation and improve oxygenation.
c. These vaccines help reduce the tachypnea these clients experience.
d. Respiratory infections can cause severe hypoxia and possibly death in these clients.

13. Exercise has which of the following effects on clients with asthma, chronic bronchitis, and emphysema?

a. It enhances cardiovascular fitness.
b. It improves respiratory muscle strength.
c. It reduces the number of acute attacks.
d. It worsens respiratory function and is discouraged.

14. Clients with chronic obstructive bronchitis are given diuretic therapy. Which of the following reasons best explains why?

a. Reducing fluid volume reduces oxygen demand.
b. Reducing fluid volume improves clients’ mobility.
c. Restricting fluid volume reduces sputum production.
d. Reducing fluid volume improves respiratory function.

15. A 69-year-old client appears thin and cachectic. He’s short of breath at rest and his dyspnea increases with the slightest exertion. His breath sounds are diminished even with deep inspiration. These signs and symptoms fit which of the following conditions?

b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema

16. A client with emphysema should receive only 1 to 3 L/minute of oxygen, if needed, or he may lose his hypoxic drive. Which of the following statements is correct about hypoxic drive?

a. The client doesn’t notice he needs to breathe.
b. The client breathes only when his oxygen levels climb above a certain point.
c. The client breathes only when his oxygen levels dip below a certain point.
d. The client breathes only when his carbon dioxide level dips below a certain point.

17. Teaching for a client with chronic obstructive pulmonary disease (COPD) should include which of the following topics?

a. How to have his wife learn to listen to his lungs with a stethoscope from Wal-Mart.
b. How to increase his oxygen therapy.
c. How to treat respiratory infections without going to the physician.
d. How to recognize the signs of an impending respiratory infection.

18. Which of the following respiratory disorders is most common in the first 24 to 48 hours after surgery?

a. Atelectasis
b. Bronchitis
c. Pneumonia
d. Pneumothorax

19. Which of the following measures can reduce or prevent the incidence of atelectasis in a post-operative client?

a. Chest physiotherapy
b. Mechanical ventilation
c. Reducing oxygen requirements
d. Use of an incentive spirometer

20. Emergency treatment of a client in status asthmaticus includes which of the following medications?

a. Inhaled beta-adrenergic agents
b. Inhaled corticosteroids
c. I.V. beta-adrenergic agents
d. Oral corticosteroids

21. Which of the following treatment goals is best for the client with status asthmaticus?

a. Avoiding intubation
b. Determining the cause of the attack
c. Improving exercise tolerance
d. Reducing secretions

22. Dani was given dilaudid for pain. She’s sleeping and her respiratory rate is 4 breaths/minute. If action isn’t taken quickly, she might have which of the following reactions?

a. Asthma attack
b. Respiratory arrest
c. Be pissed about receiving Narcan
d. Wake up on her own

23. Which of the following additional assessment data should immediately be gathered to determine the status of a client with a respiratory rate of 4 breaths/minute?

a. Arterial blood gas (ABG) and breath sounds
b. Level of consciousness and a pulse oximetry value.
c. Breath sounds and reflexes
d. Pulse oximetry value and heart sounds

24. A client is in danger of respiratory arrest following the administration of a narcotic analgesic. An arterial blood gas value is obtained. The nurse would expect to PaCO2 to be which of the following values?

a. 15 mm Hg
b. 30 mm Hg
c. 40 mm Hg
d. 80 mm Hg

25. A client has started a new drug for hypertension. Thirty minutes after he takes the drug, he develops chest tightness and becomes short of breath and tachypneic. He has a decreased level of consciousness. These signs indicate which of the following conditions?

a. Asthma attack
b. Pulmonary embolism
c. respiratory failure
d. Rheumatoid arthritis

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