EAQ Exam 3 QUESTIONS WITH DETAILED
VERIFIED ANSWERS AND RATIONALES
(100% CORRECT ANSWERS) ALEREADY
GRADED A+
1. Which time is best to obtain peak flow readings? Five
minutes after meals Between noon and 2:00 p.m.
Early in the morning on an empty stomach
Two hours after inhaling a short-acting ² 2 agonist: Between noon and 2:00
p.m.
The peak flow readings should be taken between noon and 2:00 p.m. because the
peak flow is highest during this period. The patient may feel nauseous if the peak
flow readings are taken five minutes after meals. The peak flow readings are not at
a high level early in the morning. Since the peak effect of the short-acting ² 2agonists
occurs in about 20 minutes, peak flows would be measured about 20 minutes after
administration of the medication.
2. To prevent respiratory complications of chronic
obstructive pulmonary disease, which vaccines will the nurse
plan to administer? Select all that apply.
Tetanus
Influenza
Herpes zoster
Pneumococcal
Bacille Calmette-Guérin (BCG): Influenza
Pneumococcal
The pneumococcal and influenza vaccines are important for patients with a history
of heart or lung disease to prevent viral and bacterial pneumonia. Tetanus vaccine
may be needed if there is possible exposure to Clostridium tetani but will not protect
against respiratory infection. Herpes zoster immunization will protect from shingles
,but will not prevent respiratory infections. BCG is used to protect against
tuberculosis in some countries but not in the United States.
3. Which factors are possible triggers for asthma exacerbations? Select all
that apply.
Select all that apply
Aspirin
Perfumes
Animal dander
Humid weather
Gastroesophageal reflux disease (GERD): Aspirin
Perfumes
Animal dander
Gastroesophageal reflux disease (GERD)
Aspirin and other nonsteroidal antiinflammatory drugs (NSAIDS), perfumes, animal
dander, and GERD are all possible triggers for acute asthma exacerbations.
Humidity is not an asthma trigger.
4. Which action by a patient indicates a good understanding of the best way
to determine if the prescribed metered-dose inhaler (MDI) canister is empty?
Placing it in water to see if it floats
Keeping track of the number of inhalations used
Shaking the canister while holding it next to the ear
Checking the indicator line on the side of the canister: Keeping track of the
number of inhalations used
The best method to determine when to replace an MDI for a regularly scheduled
medication is by knowing the maximum puffs available per MDI and then replacing
it when those inhalations have been used (100 puffs/2 puffs each day = 50 days).
For rescue MDI inhalers which are used only PRN, the patient will need to keep
track of the doses used. Although floating the canister in water was previously
recommended, this method may lead to water leaking into the MDI and is not
recommended now. Shaking the canister is inaccurate, as the patient may not
hear anything even if the MDI is not empty. MDIs do not have an indicator line on
the canister and most do not have a counter.
,5. Which instruction will the nurse include when teaching a patient to use a
hand-held nebulizer?
Sit in an upright position during the treatment.
Take short, shallow breaths while inhaling the medication.
Rinse the nebulizer equipment under running water once a week.
During the treatment, breathe in and hold the breath for 10 seconds.: Sit in
an upright position during the treatment.
The patient is placed in an upright position that allows for most efficient breathing to
ensure adequate penetration and deposition of the aerosolized medication. Deep
and slow breaths help ensure deposition of the medication throughout the lung. To
reduce bacterial growth, the patient is asked to wash the nebulizer equipment daily
in soap and water, rinse it with water, and soak it for 20 to 30 minutes in a 1:1 white
vinegar-water solution, followed by a water rinse and air drying. The patient is taught
to hold the breath for two to three seconds during nebulizer treatments.
6. Which information will the nurse include when educating a patient with
asthma about use of a peak flow meter?
"The peak flow meter should be used weekly."
"The peak flow meter reduces asthma attacks."
"You will need to measure peak flows soon after arising in the morning" "You
should find your personal best peak flow reading for comparison.": "You
should find your personal best peak flow reading for comparison."
It is important that the patient initially determine the personal best readings when
first using a peak flow meter to evaluate for decreasing airway function. It should be
used at least twice a day for the first two weeks to determine the patient's personal
best, which will be used to monitor airway constriction. After the personal best peak
flow is determined, daily peak flow readings are recommended. The peak flow meter
does not reduce asthma attacks; it helps monitor symptoms of asthma. Peak flows
are ideally measured between 12 noon and 2:00 p.m. because peak flows are
highest in the early afternoon.
7. When a patient is experiencing an acute asthma attack, how will the nurse
position the patient?
Supine
, Lithotomy
High-Fowler's
Reverse Trendelenburg: High-Fowler's
The goal for positioning during an asthma attack is to maximize the patient's ability
to inhale and exhale deep breaths, and the semi-to-high-Fowler's position will
allow optimal chest expansion. When the patient is supine, the abdomen can push
up against the chest and it is more difficult to fully expand the chest. The abdomen
will place pressure against the chest in the lithotomy position, making it more
difficult to fully expand the lungs. While a reverse Trendelenburg position will
decrease abdominal pressure on the chest, a more upright position is better for
chest expansion.
8. Which response by the nurse is best when a patient with asthma asks
"How will I know when my metered-dose inhaler (MDI) is empty?"
"The canister will float in water."
"There will be no sound when shaking the canister."
"Your wheezing will not improve despite inhaler use."
"You need to keep track of how many puffs you have used.": "You need to
keep track of how many puffs you have used."
The MDI canister will state how many total doses are available, and the patient will
need to track how many doses are used to avoid running out of medication. Floating
the canister in water was recommended in the past, but is no longer recommended
because water can enter the chamber. The canister may or may not produce a
sound when shaking. It is not safe for the patient to wait for wheezing to worsen
before getting a new inhaler.
9. Which assessment finding by the nurse indicates a common adverse
effect of a patient's prescribed albuterol inhaler?
Diarrhea
Headache
Tachycardia
Oral candidiasis: Tachycardia
Tachycardia is a common adverse effect of the use of inhaled ² 2-adrenergic
agonists because of its stimulant effect. Headache is not a common adverse effect
VERIFIED ANSWERS AND RATIONALES
(100% CORRECT ANSWERS) ALEREADY
GRADED A+
1. Which time is best to obtain peak flow readings? Five
minutes after meals Between noon and 2:00 p.m.
Early in the morning on an empty stomach
Two hours after inhaling a short-acting ² 2 agonist: Between noon and 2:00
p.m.
The peak flow readings should be taken between noon and 2:00 p.m. because the
peak flow is highest during this period. The patient may feel nauseous if the peak
flow readings are taken five minutes after meals. The peak flow readings are not at
a high level early in the morning. Since the peak effect of the short-acting ² 2agonists
occurs in about 20 minutes, peak flows would be measured about 20 minutes after
administration of the medication.
2. To prevent respiratory complications of chronic
obstructive pulmonary disease, which vaccines will the nurse
plan to administer? Select all that apply.
Tetanus
Influenza
Herpes zoster
Pneumococcal
Bacille Calmette-Guérin (BCG): Influenza
Pneumococcal
The pneumococcal and influenza vaccines are important for patients with a history
of heart or lung disease to prevent viral and bacterial pneumonia. Tetanus vaccine
may be needed if there is possible exposure to Clostridium tetani but will not protect
against respiratory infection. Herpes zoster immunization will protect from shingles
,but will not prevent respiratory infections. BCG is used to protect against
tuberculosis in some countries but not in the United States.
3. Which factors are possible triggers for asthma exacerbations? Select all
that apply.
Select all that apply
Aspirin
Perfumes
Animal dander
Humid weather
Gastroesophageal reflux disease (GERD): Aspirin
Perfumes
Animal dander
Gastroesophageal reflux disease (GERD)
Aspirin and other nonsteroidal antiinflammatory drugs (NSAIDS), perfumes, animal
dander, and GERD are all possible triggers for acute asthma exacerbations.
Humidity is not an asthma trigger.
4. Which action by a patient indicates a good understanding of the best way
to determine if the prescribed metered-dose inhaler (MDI) canister is empty?
Placing it in water to see if it floats
Keeping track of the number of inhalations used
Shaking the canister while holding it next to the ear
Checking the indicator line on the side of the canister: Keeping track of the
number of inhalations used
The best method to determine when to replace an MDI for a regularly scheduled
medication is by knowing the maximum puffs available per MDI and then replacing
it when those inhalations have been used (100 puffs/2 puffs each day = 50 days).
For rescue MDI inhalers which are used only PRN, the patient will need to keep
track of the doses used. Although floating the canister in water was previously
recommended, this method may lead to water leaking into the MDI and is not
recommended now. Shaking the canister is inaccurate, as the patient may not
hear anything even if the MDI is not empty. MDIs do not have an indicator line on
the canister and most do not have a counter.
,5. Which instruction will the nurse include when teaching a patient to use a
hand-held nebulizer?
Sit in an upright position during the treatment.
Take short, shallow breaths while inhaling the medication.
Rinse the nebulizer equipment under running water once a week.
During the treatment, breathe in and hold the breath for 10 seconds.: Sit in
an upright position during the treatment.
The patient is placed in an upright position that allows for most efficient breathing to
ensure adequate penetration and deposition of the aerosolized medication. Deep
and slow breaths help ensure deposition of the medication throughout the lung. To
reduce bacterial growth, the patient is asked to wash the nebulizer equipment daily
in soap and water, rinse it with water, and soak it for 20 to 30 minutes in a 1:1 white
vinegar-water solution, followed by a water rinse and air drying. The patient is taught
to hold the breath for two to three seconds during nebulizer treatments.
6. Which information will the nurse include when educating a patient with
asthma about use of a peak flow meter?
"The peak flow meter should be used weekly."
"The peak flow meter reduces asthma attacks."
"You will need to measure peak flows soon after arising in the morning" "You
should find your personal best peak flow reading for comparison.": "You
should find your personal best peak flow reading for comparison."
It is important that the patient initially determine the personal best readings when
first using a peak flow meter to evaluate for decreasing airway function. It should be
used at least twice a day for the first two weeks to determine the patient's personal
best, which will be used to monitor airway constriction. After the personal best peak
flow is determined, daily peak flow readings are recommended. The peak flow meter
does not reduce asthma attacks; it helps monitor symptoms of asthma. Peak flows
are ideally measured between 12 noon and 2:00 p.m. because peak flows are
highest in the early afternoon.
7. When a patient is experiencing an acute asthma attack, how will the nurse
position the patient?
Supine
, Lithotomy
High-Fowler's
Reverse Trendelenburg: High-Fowler's
The goal for positioning during an asthma attack is to maximize the patient's ability
to inhale and exhale deep breaths, and the semi-to-high-Fowler's position will
allow optimal chest expansion. When the patient is supine, the abdomen can push
up against the chest and it is more difficult to fully expand the chest. The abdomen
will place pressure against the chest in the lithotomy position, making it more
difficult to fully expand the lungs. While a reverse Trendelenburg position will
decrease abdominal pressure on the chest, a more upright position is better for
chest expansion.
8. Which response by the nurse is best when a patient with asthma asks
"How will I know when my metered-dose inhaler (MDI) is empty?"
"The canister will float in water."
"There will be no sound when shaking the canister."
"Your wheezing will not improve despite inhaler use."
"You need to keep track of how many puffs you have used.": "You need to
keep track of how many puffs you have used."
The MDI canister will state how many total doses are available, and the patient will
need to track how many doses are used to avoid running out of medication. Floating
the canister in water was recommended in the past, but is no longer recommended
because water can enter the chamber. The canister may or may not produce a
sound when shaking. It is not safe for the patient to wait for wheezing to worsen
before getting a new inhaler.
9. Which assessment finding by the nurse indicates a common adverse
effect of a patient's prescribed albuterol inhaler?
Diarrhea
Headache
Tachycardia
Oral candidiasis: Tachycardia
Tachycardia is a common adverse effect of the use of inhaled ² 2-adrenergic
agonists because of its stimulant effect. Headache is not a common adverse effect
