NUR 112 EXAM 3 QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2026

NUR 112 EXAM 3 QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2026 Chronic inflammatory disease Recurrent episodes wheezing, breathlessness Airways in persistent state of inflammation Trigger causes acute response Late phase 4-12 hours after Eczema often precursor - Answers Asthma Limited expiratory airflow Hypoxemia Hyperventilation - Answers Untreated Asthma can lead to -stridor -diminished -pleural friction rub -absent - Answers Asthma lung sounds: Inflammatory mediators released Causes activation of inflammatory cells Bronchoconstriction, airway edema Increases work of breathing Trapped air mixes with inhaled air Impairs gas exchange - Answers What happens during an Asthma attack pets exercise stress/anger pollen chemicals bugs smoke dust cold air - Answers What are asthma triggers Age 6 years use diaphragm Airway more narrow O2 consumption higher Rapid muscle fatigue Age 4 mostly nasal breathers - Answers Pediatric Differences for asthma Avoiding allergies and environmental triggers Controlling dust Removing carpets Covering mattresses and pillows Pet removal - Answers Prevention of asthma Coughing - often dry cough that is worse at night; wheezing, shortness of breath, chest tightness, tachypnea, tachycardia Abrupt or insidious Frequency, severity vary Anxiety and apprehension - Answers Signs and symptoms of Asthma Peak Expiratory Flow Rate (PEFR) Allergy testing for allergic asthma CBC with differential ABG Pulmonary function study Chest x-ray Oxygen saturation monitoring - Answers asthma diagnositics Beta-2 agonists (-ol) : Albuterol (INH, PO) Anticholinergics (-tropium): ipratropium bromide/Atrovent (INH) - Answers Asthma drug therapy: short-acting Albuterol (INH, PO) Side-effect: nervousness, tachycardia Nursing Interventions/ Education: rinse mouth, cautious with cardiac patients - Answers Beta-2 agonists (-ol) (-tropium): ipratropium bromide/Atrovent (INH) SE: dry mouth, bitter taste NI: ice chips, cautious with BPH or bladder obstruction - Answers Anticholinergics Long-acting Beta2 agonist (-ol): Corticosteroids (-ide, -one) Leukotriene modifiers (-lukast) Methylxanthines Mast cell stabilize - Answers Asthma drug therapy: long-acting salmeterol SE: H/A NI: caution with cardiac disease - Answers Long-acting Beta2 agonist (-ol): budesonide/Pulmicort, fluticasone/Flovent SE: sore throat, thrush NI: give AFTER bronchodilator, rinse mouth - Answers Corticosteroids (-ide, -one) local Inhalation oral:prednisone Intravenous: methylprednisolone/Solumedrol, dexamethose/Decadron SE: hyperglycemia, HTN, r/f infection, mood swings, insomnia NI: monitor BG, watch s/s infection - Answers Corticosteroids (-ide,-one) Systemic Oral and IV : theophylline (PO) SE: tachycardia, nervous, GI irritation NI: watch blood levels for toxicity - Answers Methylxanthines: montelukast (PO) SE: suicidal thoughts NI: monitor liver function tests, interactions with warfarin and theophylline - Answers Leukotriene modifiers (-lukast): Cromolyn (INH) SE: cough, irritating, bad taste NI: may take weeks for effects - Answers Mast cell stabilizer: Symptoms 2 a month: Intermittent Symptoms 3-4 times a month: Mild Symptoms 1 time per week : Moderate Symptoms often 7 times per week: Severe - Answers Classification of asthma severity Inhaler with spacer: open, shake, insert into spacer, press down, slow deep breath and hold breath 10 second, (if another puff needed, wait 30secons then repeat) drink or brush teeth - Answers Asthma nursing education Status asthmaticus Acute respiratory failure Pneumonia Atelectasis - Answers Asthma complications Wheezing or diminished lung sounds Respiratory distress Tests: CXR, ABG, CBC, SpO2, CBC w diff - Answers Status asthmaticus Medications Hydration Stress free environment Positioning( Pillows are places behind the back and other pillows are placed on the overhead table to support arms, shoulders and head) - Answers Care for Status asthmaticus COPD: onset mid life symptoms slowly progress long smoking history Asthma: Onset early symptoms vary day to day symptoms worse at night/early moring allergy, rhinitis, and or eczma also present family history of asthma - Answers Asthma Vs COPD Air in the pleural space causing the lung to collapse - Answers Pneumothorax Blood in the pleural cavity - Answers What is a hemothorax Trauma Disease process - CF, Pneumonia, Asthma, COPD Spontaneous Occurs suddenly Most common in underweight male cigarette smokers between 20 and 40 Years Tendency to recur Mechanical ventilation Insertion of subclavian catheters Perforation of esophagus Ruptured blebs - Answers Causes of Pneumothorax Abnormalities of the viseral pleural (viseral is the inner pleural) due to inflammation, they are most commonly due to smoking - Answers What are blebs Apply a dressing to the site The dressing should be left open (untapped) on one side to allow air and blood to escape and avoid the build up of tension in the pleural cavity that could result in a tension pneumothorax - Answers What initial action is required at the site of an open sucking chest would Dyspnea, Decreased movement of the involved chest wall, diminished or absent breath sounds on the affected side, Sharp chest pain on inspiration - Answers S&S of Pneumothorax During the procedure you should monitor their RR, O2 sat, HR and B/P closely as the physicians focus will be on placing the tube. - Answers What do the nurses monitor during a chest tube placement? Below the chest at ALL times. - Answers Where should a chest tube drainage system be placed? Fluid will collect in the loop, creating back pressure on the chest - Answers Why should chest tube tubing be coiled on the bed instead of being allowed to hang in a loop over the bed All connections should be taped. Check connections regularly. Protect connections from accidental disconnection. - Answers How do you prevent a chest tube air leak? Locate source of leak Clamp close to chest Bubbling stops: leak at insertion site or within thorax Clamp toward CDU Bubbling stops: leak within the tubing Intervene accordingly Tighten connection Replace drainage system Call MD to replace tube if leak within thorax - Answers How do you determine an air leak in a chest tube? Instruct client to: Exhale as much as possible Cough to remove as much air as possible from the pleural space Cleanse the tips and reconnect the tubing - Answers What do you do if a tube becomes accidentally disconnected? If the system breaks immerse the end of the tube in sterile water to restore the water seal, until you can set up and connect a new CT drainage system - Answers What do you do if the CT Drainage system breaks? An occlusive dressing taped on only three sides should be immediately placed over the insertion site - Answers What do you do if the chest tube is ACCIDENTALLY removed? Sterile airtight (taped on all four sides) petroleum jelly gauze dressing - Answers What do you do if the chest tube is removed per Dr. orders? Two covered hemostats A bottle of sterile water Occlusive dressing - Answers If a patient has a chest tube, what should be kept at the bedside? Deviation of the trachea away from the side with the tension, Tachycardia Hypotension Hypoxia Hyper-expanded chest, that moves little with respiration. - Answers S&S of a tension pneumothorax is a highly contagious viral respiratory infection. - Answers what is influenza self limiting with symptoms; fever, rhinorrhea (nasal discharge), cough, headache and malaise, chills - Answers S&S influenza widespread outbreak - Answers Epidemic global outbreak - Answers Pandemic droplet and direct contact, so isolation precautions should include: Gloves Gown Facemask - Answers what isolation precautions is influenza Bedrest, fluids, Hygiene (hand washing, covering nose and mouth when coughing or sneezing, disposal of infected tissues) Isolation precautions for hospitalized patients Antiviral Antivirals must be given within 2 days of symptoms developing Oseltamivir (Tamiflu) Zanamivir (Relenza) is given by inhalation so is not recommended for patients with COPD or asthmatics - Answers Influenza treatment Airway obstruction can result from Foreign objection instruction Sputum Narrowing of the airways through inflammation resulting from infection or irritants (cigarette smoke, pollen, chemicals, pollution, allergens) - Answers What can cause an airway obstruction Aging Air pollution Altered consciousness Prolonged immobility Chronic diseases HIV/AIDS Immunosuppressive drugs Inhalation/aspiration of noxious substances Malnutrition Smoking Tracheal intubation URI's - Answers What factors predispose patients to pneumonia Filtration of air Mucociliary Clearance Cough Reflex Reflex Bronchoconstriction Alveolar Macrophages - Answers In older adults several of our respiratory defense mechanisms are reduced, what are our respiratory defense mechanisms filter warm and humidify air - Answers What do our nasal cavities do Aspiration Prevent it by raising Head of bed (HOB) at30 degrees - Answers What complication might you expect in a patient with a suppressed or absent cough reflex bacteria fungal viral - Answers What are the 3 causes of pneumonia Community acquired-w/in 48 hr of hospitalization hospital acquired-develop signs 48 hrs after admission ventilator acquired aspiration - Answers what are the 4 classifications of pneumonia HOB elevated 30-45 degrees Medication to prevent stomach ulcers Vigorous oral hygiene Hand Hygiene Early weaning - Answers What are the 5 elements of a VAP bundle ↓ LOC Seizures Anesthesia Stroke ETOH /drug ingestion - Answers What patients are prone to aspiration fever chills cough w/phlem SOB fatigue headache loss of appetite mood swings high HR low BP Retractions - Answers S&S of Pneumonia history and physical CXR sputum specimen for gram stain and C&S blood cultures - Answers Pneumonia diagnostics Antibiotics possible Tamiful - Answers Pneumonia treatment Position (HOB elevated, frequent reposition to mobilize secretions) Secretion Clearance Encourage Deep Breathing & Coughing (incentive spirometry Encourage fluids to liquefy secretions Acapella airway clearance device Chest PT Postural Drainage & Percussion (PDP) or Postural Drainage & Vibration - Answers what do we do to maintain an airway Airway Maintenance Oxygen Administration Monitor Vital signs Pharmacology Antibiotics Pain medications(Tylenol) Antipyretic - Answers Pneumonia nursing interventions 65- its a 1 time vaccine (may receive it earlier due to situational dependency - Answers At what age do you typically get the Pneumonia vaccine? Lung abscess More common with gram neg. & staph pneumonias Empyema