OXYGENATION TEST KEY ASTHMA/ COPD

1.) A patient has exercise-induced asthma. Which of the following actions can the patient perform to
help prevent an attack during exercise.

Administer a short-acting beta agonist before exercise.

Avoid exercising when experiencing a respiratory illness.

2.)A patient received a nebulizer of Albuterol. What is a side effect of this medication?

Tachycardia

3.)A patient with asthma is prescribed to take inhaled Salmeterol and Fluticasone for long-term
management of asthma. You observe the patient taking these medications. Which option below best
describes the correct order in how to take these medications?

The patient inhales the Salmeterol first and then waits 5 minutes before inhaling the Fluticasone. The
bronchodilator inhaler (Salmeterol) is administered first to open up the airways. Then the patient is to
wait five minutes and then administer the corticosteroid (Fluticasone). The bronchodilator will open
the airways so the corticosteroid can easily enter the airways to decrease inflammation.

4.)A patient with asthma is receiving a nebulizer of Cromolyn. The patient reports a burning sensation in
the nose along with a horrible taste in their mouth. As the nurse you will?

Reassure the patient this is a temporary side effect of this medication. Cromolyn can temporarily
cause the following side effects during administration: sneezing, burning in nose, itchy/watery eyes,
bad taste in mouth. Reassure the patient that these are temporary side effects of this medication.

5.)The physician orders the patient to start taking Omalizumab. How will you administer this medication
as the nurse?

Subcutaneously

6.)Select all the correct options that represent the pathophysiology of an asthma attack.

The mucosa lining experiences severe inflammation.

The goblet cells within the mucosa lining produce excessive amounts of mucous.

7.)Select all the following that can trigger an asthma attack:

Sulfites, Smoke, GERD, Cold, windy weather, and Cockroaches Caffeine has the same properties as
theophylline, which is a bronchodilator and is not known to cause asthma. In addition, beta adrenergic
blockers that are nonselective (NOT beta agonist...which are used to treat asthma) can cause an
asthma attack.

8.)Which medication below blocks the function of Leukotriene for the treatment of asthma?
Montelukast

9.)You assist your patient with using their inhaler. The inhaler contains the medication Budesonide.
Before administering the inhaler, you will want to connect what device to the inhaler to help decrease
the patient from developing ________?

Spacer; thrush Budesonide is a corticosteroid. Inhaled corticosteroids can cause thrush. Therefore, it is
important to connect a spacer to the inhaler before usage to help prevent the patient from developing
thrush and for the patient to gargle and rinse the mouth with water.

10.)Your assisting your patient who has asthma to bed. The patient is experiencing a frequent cough and
chest tightness. You auscultate the patient's lung fields and note expiratory wheezes. The patient's peak
flow rate is 78% less than their best peak flow reading. Which medication will provide the patient with
the fastest relief from these signs and symptoms of an asthma attack?

Albuterol During an asthma attack, the patient needs a medication that will quickly open the airways.
Medications that are best for this include short-acting bronchodilators, such as Albuterol, short-acting
beta agonists. Another type of short-acting bronchodilator is an anticholinergic bronchodilator called
Ipratropium (this is given if a patient can't tolerated short-acting beta agonists like Albuterol).
Theophylline is a bronchodilator but given orally and is NOT for quick relief. Tiotropium is a
bronchodilator, as well, but is a LONG-ACTING anticholinergic bronchodilator. Cromolyn is an inhaled
nonsteroidal anti-allergy medication that doesn't provide quick relief.

11.) Your educating a patient how to use a peak flow meter to help monitor the status of their asthma.
Which statement by the patient demonstrates they understand how to use the device?

"I will use this device at the same time, either in the morning or before bedtime, and compare the
readings with my personal best reading."

12.) You're providing discharge teaching to a patient who was admitted with asthma. You discussed the
early warning signs of an asthma attack and ask the patient to list some of them. Select all the correct
early warning signs verbalized by the patient:

Easily fatigued with physical activity,

Reduced peak flow meter reading,

Wheezing with activity

Nighttime coughing
These are all early warning signs an asthma attack is imminent.

13.)Your patient's asthma is poorly controlled. The patient reports using their rescue inhaler 4 times a
week. In addition, the patient's asthma is not responding to other treatments. The physician orders the
patient to take a medication that works by blocking the role of the immunoglobulin IgE. This describes
which medication below?
Omalizumab blocks the role of the immunoglobulin IgE, which will decrease the allergic
response...hence asthma attacks. It is given subcutaneously and used when a patient's asthma is
poorly controlled and other treatments are not working. It is NOT used for quick relief. It is important
the patient receives NO LIVE vaccines while receiving this medication.

14.) Your patient with asthma is taking Theophylline. Which product below should the patient avoid
consuming?

Caffeine has the same properties as Theophylline and can increase the effects the drug.

COPD NCLEX Questions

1. True or False: COPD is reversible and tends to happens gradually.

2. A patient is presenting with chronic obstructive pulmonary disease. The patient has a chronic
productive cough with dyspnea on excretion. Arterial blood gases show a low oxygen level and
high carbon dioxide level in the blood. On assessment, the patient has cyanosis in the lips and
edema in the abdomen and legs. Based on your nursing knowledge and the patient's
symptoms, you suspect the patient suffers from what type of COPD?

A. Emphysema

B. Pneumonia

C. Chronic bronchitis

D. Pneumothorax

3. A patient with emphysema may present with all of the following symptoms EXCEPT?

A. Barrel chest

B. Hyperinflation of the lung

C. Hypoventilation

D. Hypercapnia

4. The term blue bloater is used to describe patients with?

A. Pulmonary hypertension

B. Left-sided heart failure

D. Emphysema

5. A patient is newly diagnosed with COPD due to chronic bronchitis. You're providing education
to the patient about this disease process. Which statement by the patient indicates they
understood your teaching about this condition?

A. "If I stop smoking, it will cure my condition."

B. "Complications from this condition can lead to pulmonary hypertension and right-sided heart
failure."

C. "I'm at risk for low levels of red blood cells due to hypoxia and may require blood transfusions
during acute illnesses."

D. "My respiratory system is stimulated to breathe due to high carbon dioxide levels rather than
low oxygen levels, as with people who have healthy lungs.

6. An alarm beeps notifying you that one of your patient's oxygen saturation is reading 89%.
You arrive to the patient's room, and see the patient comfortably resting in bed watching
television. The patient is already on 2 L of oxygen via nasal cannula. The patient is admitted for
COPD exacerbation. Your next nursing action would be:

A. Continue to monitor the patient

B. Increase the patient's oxygen level to 3 L

C. Notify the doctor for further orders

D. Turn off the alarm settings

7. You are providing teaching to a patient with chronic COPD on how to perform diaphragmatic
breathing. This technique helps do the following:

A. Increase the breathing rate to prevent hypoxemia

B. Decrease the use of the abdominal muscles

C. Encourages the use of accessory muscles to help with breathing

D. Strengthen the diaphragm

A. Spiriva

B. Salmeterol

C. Symbicort

D. Albuterol

9. Which of the following statements are incorrect about discharge teaching that you would
provide to a patient with COPD? Select-all-that-apply:

A. "It is best to eat three large meals a day that are relatively low in calories."

B. "Avoid going outside during extremely hot or cold days."

C. "It is important to receive the Pneumovax vaccine annually."

D. "Smoking cessation can help improve your symptoms."

10. A patient is ordered by the physician to take Pulmicort and Spiriva via inhaler. How should
the patient take this medication?

A. The patient should use the medications every 2 hours for acute episodes of shortness of
breath.

B. The patient should use the Spiriva first and then 5 minutes later the Pulmicort.

C. The patient should use the Pulmicort first and then the Spiriva 5 minutes later.

D. The patient should use the medications at the same exact time, regardless of the order.

11. In regards to question 10, which action by the patient demonstrates they know how to
properly use this medication?

A. The patient rinses their mouth after using the Spiriva inhaler.

B. The patient rinses their mouth after using the Pulmicort inhaler.

C. The patient dispenses of the inhalers.

12. A patient with COPD is reporting depression and thoughts of suicide. The patient states, "I
just feel like ending it all." You assess the patient's health history and note that the patient was
recently started on which medication that could cause this side effect:

A. Atrovent

B. Prednisone

C. Roflumilast

D. Theophylline

13. A patient is ordered at 1400 to take Theophylline. You're assessing the patient's morning lab
results and note that the Theophylline level drawn this morning reads: 15 mcg/mL. You're next
nursing action is to?

A. Administer the dose at 1400 as ordered

B. Notify the physician for further orders

C. Hold the 1400 dose

D. Collect another blood sample to confirm the level

14. You are providing care to a patient with COPD who is receiving medical treatment for
exacerbation. The patient has a history of diabetes, hypertension, and hyperlipidemia. The
patient is experiencing extreme hyperglycemia. In addition, the patient has multiple areas of
bruising on the arms and legs. Which medication ordered for this patient can cause
hyperglycemia and bruising?

A. Prednisone

B. Atrovent

C. Flagyl

D. Levaquin