🫁 Asthma Attack!
What happens to the airways during an asthma episode?
ANSWER: Bronchoconstriction and airway inflammation.
RATIONALE: Airway narrowing limits airflow and produces breathing difficulty.
What does COPD interfere with most directly?
ANSWER: Airflow through the lungs.
RATIONALE: Chronic airflow limitation contributes to dyspnea and reduced activity tolerance.
What does OSA stand for?
ANSWER: Obstructive sleep apnea.
RATIONALE: Upper airway obstruction occurs repeatedly during sleep.
What oxygen flow range is commonly used with a standard nasal cannula?
ANSWER: 1–6 L/min.
RATIONALE: This low-flow device provides an approximate FiO₂ of 24–44%, depending on conditions.
Which high-pitched airway sound can signal upper airway obstruction?
ANSWER: Stridor.
RATIONALE: Stridor is an important cue of possible airway narrowing requiring prompt assessment.
Which medication provides rapid relief of acute bronchospasm?
ANSWER: Albuterol (a short-acting beta₂ agonist).
RATIONALE: A SABA quickly relaxes airway smooth muscle.
Which medication class includes tiotropium and is commonly used for COPD maintenance?
ANSWER: Long-acting muscarinic antagonists (LAMAs).
RATIONALE: Long-acting bronchodilation helps maintain airflow over time.
What treatment uses positive pressure to help keep the upper airway open during sleep?
ANSWER: CPAP.
RATIONALE: Continuous positive airway pressure supports airway patency.
What is the minimum oxygen flow for a simple face mask?
ANSWER: At least 5 L/min.
RATIONALE: A simple mask is generally operated at 5–10 L/min.
A patient with an airway obstruction develops retractions and altered consciousness. What takes priority?
ANSWER: Airway patency and emergency escalation.
RATIONALE: These are signs of potentially severe respiratory compromise.
Which inhaled medication class reduces airway inflammation with regular use but is not a rescue treatment?
ANSWER: Inhaled corticosteroids, such as fluticasone or budesonide.
RATIONALE: They help control inflammation over time rather than immediately reverse bronchospasm.
What should the nurse assess to evaluate whether COPD maintenance treatment is working?
ANSWER: Dyspnea, activity tolerance, breath sounds, and inhaler technique.
RATIONALE: Symptom trends and correct administration help evaluate long-term management.
Which daytime symptom may improve when OSA is treated effectively?
ANSWER: Excessive daytime sleepiness.
RATIONALE: Better nighttime breathing can improve daytime alertness.
Which oxygen device uses an adapter to deliver a prescribed, controlled FiO₂?
ANSWER: Venturi mask.
RATIONALE: The nurse must select the correct adapter and matching flow setting.
A patient has low pH and elevated PaCO₂. Which respiratory acid–base disorder is suggested?
ANSWER: Respiratory acidosis.
RATIONALE: Inadequate CO₂ elimination increases acidity.
When a bronchodilator and corticosteroid inhaler are prescribed separately, which is given first?
ANSWER: The bronchodilator.
RATIONALE: Opening the airways first helps the subsequently administered inhaled medication reach the airways.
Which prescribed oxygen saturation range may be used for a hypoxic patient with COPD?
ANSWER: 88–92%.
RATIONALE: A controlled oxygen target may be ordered while the nurse monitors oxygenation and CO₂ retention.
What should the nurse assess when a patient reports difficulty using CPAP?
ANSWER: Mask seal, fit, comfort, adherence, and equipment cleaning.
RATIONALE: Practical device problems can interfere with consistent therapy.
What must the nurse check on a nonrebreather mask during oxygen delivery?
ANSWER: The reservoir bag remains partially inflated.
RATIONALE: A nonrebreather generally uses 10–15 L/min and requires close assessment of oxygenation and breathing.
A patient is breathing rapidly and has elevated pH with low PaCO₂. Which disorder is suggested?
ANSWER: Respiratory alkalosis.
RATIONALE: Excessive CO₂ elimination raises blood pH.
A patient uses salmeterol alone for asthma and expects it to stop an acute attack. What teaching is needed?
ANSWER: Salmeterol is not a rescue inhaler and should not be used alone for asthma.
RATIONALE: A LABA is for longer-acting prevention and must not be used as asthma monotherapy.
A patient with COPD becomes increasingly sleepy and has rising PaCO₂. What problem should the nurse suspect?
ANSWER: Carbon dioxide retention and inadequate ventilation.
RATIONALE: Rising PaCO₂ with altered consciousness suggests worsening ventilation and requires prompt reassessment.
Why should a patient with OSA discuss sedative use with the healthcare team?
ANSWER: Sedatives can worsen upper airway obstruction during sleep.
RATIONALE: Medication review is part of safe OSA management; sedatives do not correct the underlying obstruction.
A patient on oxygen becomes more distressed despite the prescribed device. What should the nurse do?
ANSWER: Reassess breathing effort and oxygenation promptly and escalate care.
RATIONALE: Oxygen delivery does not replace recognition of worsening respiratory status.
A patient using an inhaled corticosteroid develops oral irritation. Which preventive teaching is appropriate?
ANSWER: Perform mouth care or rinse the mouth after use.
RATIONALE: Mouth care helps reduce the risk of oral yeast infection associated with inhaled corticosteroids.