NSG 3800/3850 Exam 2 UPDATED
QUESTIONS AND CORRECT ANSWERS
Acute Bronchitis Patho - CORRECT ANSWER Acute inflammation of the trachea and bronchi
caused by
inflammed airway and narrowed from capillary dilation
Swelling from fluid exudation
Increased mucus production
Loss of ciliary function
Loss of portions of the ciliated epithelium
Acute Bronchitis Etiology - CORRECT ANSWER Viral or non-viral
Coronavirus
Heat
Smoke inhalation
Allergic reactions
Acute Bronchitis S/S - CORRECT ANSWER DISTINCT HALLMARK OF DISEASE:
RECENT ONSET OF COUGH
Low grade fever
Substernal chest discomfort
Sore throat
Postnasal drip
Chronic Bronchitis Risk factors - CORRECT ANSWER Cigarette smoking
Overweight
Genetic predisposition
Inhalation of physical or chemical irritants
Chronic or recurrent productive cough
,Chronic bronchitis patho - CORRECT ANSWER Hyperplasia of bronchial mucous
gland/goblet cells
Increased mucous production with formation of mucous plugs
Increased bronchial wall thickness
INCREASED PULMONARY ARTERY RESISTANCE LEADS TO PULMONARY HTN
Chronic bronchitis s/s - CORRECT ANSWER BLUE BOATER
Overweight
Hypoxia
Hypercapnia
Acidosis
Exertional dyspnea
Digital clubbing
Cardiomegaly
Accessory muscles
What is COPD and what conditions are classified as COPD? - CORRECT ANSWER Chronic
airflow limitation
Emphysema and Chronic bronchitis
Emphysema Patho/Etiology - CORRECT ANSWER abnormal distention of alveoli
Antitrypsin deficiency (caused from nicotine)
Smoking
Air pollution
Occupational environments
What is Antitrypsin and what condition is it associated with? - CORRECT ANSWER A1-
Antitrypsin is a protein produced in the liver that protects the body's tissues from being damaged by
infection fighting agents released by its immune system.
Inhibits neutrophil elastase activity in the lung protecting it from proteolytic damage
,Deficiency is rare inherited disorder that causes lung disease and liver disease
Associated with emphysema
Emphysema S/S - CORRECT ANSWER Pink puffer (good gas exchange but increased
respiratory effort)
Pursed lip breathing
Accessory muscles
Barrel chest
Thin, wasted individual hunched forward (r/t increased respiratory effort and resulting caloric
expenditure with decreased ability to consume adequate calories)
Prolonged expiration
Clubbing
Emphysema complications - CORRECT ANSWER Pneumothorax due to bullae
Weight loss due to work of breathing
Bronchitis complications - CORRECT ANSWER Secondary polycythemia
Pulmonary hypertension
Cor pulmonale (R sided heart failure)
COPD Nursing care - CORRECT ANSWER Pulmonary secretion removal
Education on controlled coughing (maximal inspiration followed by breath-holding and then two or
three coughs)
Huff coughing (one to two forced exhalations from a low to medium lung volumes with the glottis
open)
Chest physiotherapy
Increased fluid intake
What immunization does the nurse recommend patients with COPD to have? - CORRECT
ANSWER Flu and pneumococcal pneumonia
, Monitoring and managing potential COPD complications - CORRECT ANSWER - cognitive
changes can indicate hypoxemia and impending resp failure
- Ask patient to report subtle changes such as fever, changes in sputum color, character, consistency,
or amount
- ask patient about any worsening symptoms
- assess triggers that cause bronchospasms
- assess s/s of pneumothorax (symmetry of chest, breath sound differences, pulse ox)
COPD medical care - CORRECT ANSWER - promote smoking cessation
- manage exacerbations
- supplemental o2
- Keep pulse ox on
- Pulmonary rehab
What is the risk of O2 treatment in patients with COPD? - CORRECT ANSWER - CO2 is
constantly high so they burn out their CO2 receptors (Hypercapnia)
- Brain doesn't sense the increased CO2 in the same way so now it starts to look instead for low O2
levels
- So if we then give our COPD patient too much O2 - their brain says, "well - I have enough O2 - I
can decrease the respiratory rate"
- This is dangerous for our COPD patients, they're already struggling to breathe
- COPD patients breath because the brain senses low O2 levels
Corticosteroids/Bronchodilators (Budesonide) - CORRECT ANSWER - Decreases
inflammation
- Relieve bronchospasm
- Long term management of disease
- Short term flare ups
Beta-adrenergic agonist (Albuterol) - CORRECT ANSWER - Relieve bronchospasm by
improving expiratory flow through widening of the airways and promoting lung emptying with each
breath
QUESTIONS AND CORRECT ANSWERS
Acute Bronchitis Patho - CORRECT ANSWER Acute inflammation of the trachea and bronchi
caused by
inflammed airway and narrowed from capillary dilation
Swelling from fluid exudation
Increased mucus production
Loss of ciliary function
Loss of portions of the ciliated epithelium
Acute Bronchitis Etiology - CORRECT ANSWER Viral or non-viral
Coronavirus
Heat
Smoke inhalation
Allergic reactions
Acute Bronchitis S/S - CORRECT ANSWER DISTINCT HALLMARK OF DISEASE:
RECENT ONSET OF COUGH
Low grade fever
Substernal chest discomfort
Sore throat
Postnasal drip
Chronic Bronchitis Risk factors - CORRECT ANSWER Cigarette smoking
Overweight
Genetic predisposition
Inhalation of physical or chemical irritants
Chronic or recurrent productive cough
,Chronic bronchitis patho - CORRECT ANSWER Hyperplasia of bronchial mucous
gland/goblet cells
Increased mucous production with formation of mucous plugs
Increased bronchial wall thickness
INCREASED PULMONARY ARTERY RESISTANCE LEADS TO PULMONARY HTN
Chronic bronchitis s/s - CORRECT ANSWER BLUE BOATER
Overweight
Hypoxia
Hypercapnia
Acidosis
Exertional dyspnea
Digital clubbing
Cardiomegaly
Accessory muscles
What is COPD and what conditions are classified as COPD? - CORRECT ANSWER Chronic
airflow limitation
Emphysema and Chronic bronchitis
Emphysema Patho/Etiology - CORRECT ANSWER abnormal distention of alveoli
Antitrypsin deficiency (caused from nicotine)
Smoking
Air pollution
Occupational environments
What is Antitrypsin and what condition is it associated with? - CORRECT ANSWER A1-
Antitrypsin is a protein produced in the liver that protects the body's tissues from being damaged by
infection fighting agents released by its immune system.
Inhibits neutrophil elastase activity in the lung protecting it from proteolytic damage
,Deficiency is rare inherited disorder that causes lung disease and liver disease
Associated with emphysema
Emphysema S/S - CORRECT ANSWER Pink puffer (good gas exchange but increased
respiratory effort)
Pursed lip breathing
Accessory muscles
Barrel chest
Thin, wasted individual hunched forward (r/t increased respiratory effort and resulting caloric
expenditure with decreased ability to consume adequate calories)
Prolonged expiration
Clubbing
Emphysema complications - CORRECT ANSWER Pneumothorax due to bullae
Weight loss due to work of breathing
Bronchitis complications - CORRECT ANSWER Secondary polycythemia
Pulmonary hypertension
Cor pulmonale (R sided heart failure)
COPD Nursing care - CORRECT ANSWER Pulmonary secretion removal
Education on controlled coughing (maximal inspiration followed by breath-holding and then two or
three coughs)
Huff coughing (one to two forced exhalations from a low to medium lung volumes with the glottis
open)
Chest physiotherapy
Increased fluid intake
What immunization does the nurse recommend patients with COPD to have? - CORRECT
ANSWER Flu and pneumococcal pneumonia
, Monitoring and managing potential COPD complications - CORRECT ANSWER - cognitive
changes can indicate hypoxemia and impending resp failure
- Ask patient to report subtle changes such as fever, changes in sputum color, character, consistency,
or amount
- ask patient about any worsening symptoms
- assess triggers that cause bronchospasms
- assess s/s of pneumothorax (symmetry of chest, breath sound differences, pulse ox)
COPD medical care - CORRECT ANSWER - promote smoking cessation
- manage exacerbations
- supplemental o2
- Keep pulse ox on
- Pulmonary rehab
What is the risk of O2 treatment in patients with COPD? - CORRECT ANSWER - CO2 is
constantly high so they burn out their CO2 receptors (Hypercapnia)
- Brain doesn't sense the increased CO2 in the same way so now it starts to look instead for low O2
levels
- So if we then give our COPD patient too much O2 - their brain says, "well - I have enough O2 - I
can decrease the respiratory rate"
- This is dangerous for our COPD patients, they're already struggling to breathe
- COPD patients breath because the brain senses low O2 levels
Corticosteroids/Bronchodilators (Budesonide) - CORRECT ANSWER - Decreases
inflammation
- Relieve bronchospasm
- Long term management of disease
- Short term flare ups
Beta-adrenergic agonist (Albuterol) - CORRECT ANSWER - Relieve bronchospasm by
improving expiratory flow through widening of the airways and promoting lung emptying with each
breath
