Rasmussen Nursing II Exam 2-Questions with Correct Answers/
Verified/ latest Update (2024/2025)
COPD - ✔️✔️Limited Airflow (due to thick and swollen bronchioles that have become deformed
with excessive sputum production and this narrows the airways)
Inability to fully exhale (due to loss of elasticity of the alveoli sacs from damage and the sacs start to
develop air pockets)
Irreversible once developed...cases vary among people from mild to severe...managed with lifestyle
changes and medications.
Happens gradually....most people start to notice signs and symptoms middle-aged and will present
with dyspnea with activity they could normally tolerate, recurrent lung infections, chronic cough etc.
COPD is a term used as a "catch all" for diseases that limit airflow and cause dyspnea.
Types of COPD - ✔️✔️Emphysema "pink puffers"
Chronic bronchitis "blue bloaters"
"Blue bloaters" - ✔️✔️The name "blue bloaters" is due to cyanosis from "hypoxia" and bloating
from edema AND increase in lung volume. The bloating is from the effects of the lung disease on the
heart which causes right-sided heart failure. Also, less oxygen is getting into the blood and more
carbon dioxide is staying in the blood.
This leads to low blood levels and high carbon dioxide levels. Patients will have cyanosis due to a
decreased oxygen level. To compensate, the body increases RBC production and cause blood to shift
elsewhere which increases pressure in the pulmonary artery leading to pulmonary hypertension.
Pulmonary hypertension leads to right-sided heart failure (which is why you will start to see
bloating..edema in the abdomen and legs)
"Pink puffers" - ✔️✔️The name "pink puffers" comes from hyperventilation (puffing to breathe)
and pink complexion (they maintain a relatively normal oxygen level due to rapid breathing) rather
than cyanosis as in chronic bronchitis.
,In emphysema, the alveolar sacs lose their ability to inflate and deflate due to an inflammatory
response in the body. So, the sac is unable to properly deflate and inflate. Inhaled air starts to get
trapped in the sacs and this causes major hyperinflation of the lungs because the patient is retaining
so much volume.
Hyperinflation causes the diaphragm to flatten. The diaphragm plays a huge role in helping the
patient breathe effortlessly in and out. Therefore, in order to fully exhale, the patient starts to
hyperventilate and use accessory muscles to get the air out now. This leads to the barrel chest look
and during inspect it may be noted there is an INCREASED ANTEROPOSTERIOR DIAMETER.
The damage in the sacs cause the body to keep high carbon dioxide levels and low blood oxygen
levels. Inhaled oxygen will not be able to enter into the sacs for gas exchange and carbon dioxide
won't leave the cells to be exhaled.
The body tries to compensate by causing hyperventilation (increasing the respiratory rate...hence
puffer) and the patient will have less hypoxemia "pink complexion" than chronic bronchitis who have
the cyanosis because pink puffers keep their oxygen level just where it needs to be from
hyperventilation.
COPD what not to do? - ✔️✔️Oxygen must be administered with caution!
The amount shouldn't exceed 3L/minute because many people with COPD retain too much CO2
Too high of a level of O2 could suppress the person's respiratory drive (loses the natural stimulus to
breathe). So the low O2 becomes the stimulus for respiration instead of the elevated CO2.
Be careful of narcotics because they cause respiratory depression!
COPD nursing diagnoses - ✔️✔️Impaired gas exchange related to airflow obstruction from
collapsed alveoli and narrow bronchioles
Anxiety related to breathlessness, ineffective coping, and reduced socialization
Ineffective breathing pattern related to increased mucous production and air trapping
, Activity intolerance related to fatigue and hypoxemia
Nutrition imbalance, less than body requirements, related to increased energy expenditure from
breathing difficulties
COPD nursing interventions - ✔️✔️Position the client to maximize ventilation
(high‑Fowler's).
Remove environmental pollutants and encourage smoking cessation
Monitor vital signs and O2 sats frequently.
Encourage effective coughing, or suction to
remove secretions.
Encourage deep breathing and use of an
incentive spirometer.
Administer breathing treatments and medications.
Administer oxygen as prescribed in low amounts (usually 1-2L/min)
Monitor for skin breakdown around the nose and mouth from the oxygen device.
Promote adequate nutrition (but small frequent meals)
Increase fluid intake. Encourage the client to drink 2 to 3 L/day to liquefy mucus.
COPD patient teaching - ✔️✔️•Smoking cessation methods; avoid occupational or environmental
pollutants
•Energy conservation techniques (alternate activity with rest periods)
Verified/ latest Update (2024/2025)
COPD - ✔️✔️Limited Airflow (due to thick and swollen bronchioles that have become deformed
with excessive sputum production and this narrows the airways)
Inability to fully exhale (due to loss of elasticity of the alveoli sacs from damage and the sacs start to
develop air pockets)
Irreversible once developed...cases vary among people from mild to severe...managed with lifestyle
changes and medications.
Happens gradually....most people start to notice signs and symptoms middle-aged and will present
with dyspnea with activity they could normally tolerate, recurrent lung infections, chronic cough etc.
COPD is a term used as a "catch all" for diseases that limit airflow and cause dyspnea.
Types of COPD - ✔️✔️Emphysema "pink puffers"
Chronic bronchitis "blue bloaters"
"Blue bloaters" - ✔️✔️The name "blue bloaters" is due to cyanosis from "hypoxia" and bloating
from edema AND increase in lung volume. The bloating is from the effects of the lung disease on the
heart which causes right-sided heart failure. Also, less oxygen is getting into the blood and more
carbon dioxide is staying in the blood.
This leads to low blood levels and high carbon dioxide levels. Patients will have cyanosis due to a
decreased oxygen level. To compensate, the body increases RBC production and cause blood to shift
elsewhere which increases pressure in the pulmonary artery leading to pulmonary hypertension.
Pulmonary hypertension leads to right-sided heart failure (which is why you will start to see
bloating..edema in the abdomen and legs)
"Pink puffers" - ✔️✔️The name "pink puffers" comes from hyperventilation (puffing to breathe)
and pink complexion (they maintain a relatively normal oxygen level due to rapid breathing) rather
than cyanosis as in chronic bronchitis.
,In emphysema, the alveolar sacs lose their ability to inflate and deflate due to an inflammatory
response in the body. So, the sac is unable to properly deflate and inflate. Inhaled air starts to get
trapped in the sacs and this causes major hyperinflation of the lungs because the patient is retaining
so much volume.
Hyperinflation causes the diaphragm to flatten. The diaphragm plays a huge role in helping the
patient breathe effortlessly in and out. Therefore, in order to fully exhale, the patient starts to
hyperventilate and use accessory muscles to get the air out now. This leads to the barrel chest look
and during inspect it may be noted there is an INCREASED ANTEROPOSTERIOR DIAMETER.
The damage in the sacs cause the body to keep high carbon dioxide levels and low blood oxygen
levels. Inhaled oxygen will not be able to enter into the sacs for gas exchange and carbon dioxide
won't leave the cells to be exhaled.
The body tries to compensate by causing hyperventilation (increasing the respiratory rate...hence
puffer) and the patient will have less hypoxemia "pink complexion" than chronic bronchitis who have
the cyanosis because pink puffers keep their oxygen level just where it needs to be from
hyperventilation.
COPD what not to do? - ✔️✔️Oxygen must be administered with caution!
The amount shouldn't exceed 3L/minute because many people with COPD retain too much CO2
Too high of a level of O2 could suppress the person's respiratory drive (loses the natural stimulus to
breathe). So the low O2 becomes the stimulus for respiration instead of the elevated CO2.
Be careful of narcotics because they cause respiratory depression!
COPD nursing diagnoses - ✔️✔️Impaired gas exchange related to airflow obstruction from
collapsed alveoli and narrow bronchioles
Anxiety related to breathlessness, ineffective coping, and reduced socialization
Ineffective breathing pattern related to increased mucous production and air trapping
, Activity intolerance related to fatigue and hypoxemia
Nutrition imbalance, less than body requirements, related to increased energy expenditure from
breathing difficulties
COPD nursing interventions - ✔️✔️Position the client to maximize ventilation
(high‑Fowler's).
Remove environmental pollutants and encourage smoking cessation
Monitor vital signs and O2 sats frequently.
Encourage effective coughing, or suction to
remove secretions.
Encourage deep breathing and use of an
incentive spirometer.
Administer breathing treatments and medications.
Administer oxygen as prescribed in low amounts (usually 1-2L/min)
Monitor for skin breakdown around the nose and mouth from the oxygen device.
Promote adequate nutrition (but small frequent meals)
Increase fluid intake. Encourage the client to drink 2 to 3 L/day to liquefy mucus.
COPD patient teaching - ✔️✔️•Smoking cessation methods; avoid occupational or environmental
pollutants
•Energy conservation techniques (alternate activity with rest periods)
