COPD
This simple breathing technique creates backpressure to prevent early airway collapse during expiration in COPD clients.
A) Diaphragmatic breathing
B) Inspiratory muscle training
C) Pursed-lip breathing
D) High-flow nasal cannula therapy
Pursed-lip breathing
This classification of rescue inhaler is the first-line pharmacologic intervention for acute bronchospasm in an asthma attack.
A) Short-acting beta2-agonists (SABA) like albuterol
B) Long-acting muscarinic antagonists (LAMA)
C) Inhaled maintenance corticosteroids
D) Oral leukotriene receptor antagonists
Short-acting beta2-agonists (SABA) like albuterol
This essential administration timing for pancreatic enzyme replacement ensures optimal digestion and absorption of fats in clients with cystic fibrosis.
A) Given once daily at bedtime on an empty stomach
B) Administered precisely two hours after every meal is completed
C) Taken only when the client experiences abdominal cramping
D) Administering enzymes with every meal and snack
Administering enzymes with every meal and snack
COPD: Why Polycythemia Occurs
Chronic Obstructive Pulmonary Disease creates permanent airflow limitations, resulting in __________.
chronic hypoxemia (low blood oxygen levels).
Name a short acting bronchodilator
Albuterol
This high-flow oxygen intervention carries a risk of suppressing the hypoxic drive in chronically hypercapnic COPD patients.
A) Uncontrolled high-flow oxygen administration via non-rebreather mask
B) Controlled low-flow oxygen via nasal cannula at 2 L/min
C) Venturi mask delivery at precise 24 percent concentration
D) Humidified room air delivery via simple face mask
Uncontrolled high-flow oxygen administration via non-rebreather mask
This personalized zone on a peak flow meter indicates that the patient's asthma is worsening and requires immediate use of a rescue medication.
A) The Green Zone (80 to 100 percent of personal best)
B) The Blue Zone (120 percent above personal best)
C) The Red Zone (less than 50 percent of personal best)
D) The Yellow Zone (50 to 80 percent of personal best)
The Yellow Zone (50 to 80 percent of personal best)
This optimal scheduling window for chest physiotherapy relative to meal times minimizes the risk of emesis and aspiration.
A) Immediately following breakfast and dinner meals
B) One hour before meals or two hours after meals
C) Directly in the middle of a heavy meal to encourage coughing
D) Anytime during the night while the patient is asleep regardless of feeding schedules
One hour before meals or two hours after meals
__________is a musical sound generated by air forcing its way through tightly constricted, inflamed bronchioles.
Wheezing
During hot weather or exercise, a person with CF loses massive amounts of salt through perspiration. If they replace that fluid loss with plain water alone, they will develop ___________ and _________.
hyponatremic dehydration and heat prostration.
This dietary modification strategy reduces the work of breathing and prevents diaphragmatic impingement from a distended stomach in severe COPD.
A) Three large, high-carbohydrate meals spaced evenly throughout the day
B) Consuming a strictly liquid diet immediately prior to sleep hours
C) Fluid restriction during all daytime hours to prevent pulmonary edema
D) Eating small, frequent, high-calorie, high-protein meals
Eating small, frequent, high-calorie, high-protein meals
This ominous auscultatory finding during an acute asthma exacerbation indicates severe air obstruction and an impending respiratory arrest.
A) Bilateral coarse crackles in the lung bases
B) A silent chest with absent breath sounds or diminished wheezing
C) Loud, musical expiratory wheezes across all lung fields
D) Inspiratory stridor heard clearly over the trachea
A silent chest with absent breath sounds or diminished wheezing
This specific genetic transmission pattern means both parents must carry the defective CFTR gene for a child to inherit cystic fibrosis.
A) X-linked dominant inheritance
B) Autosomal dominant inheritance
C) Autosomal recessive inheritance
D) Mitochondrial maternal transmission
Autosomal recessive inheritance
With a "Silent Chest" the airways are so obstructed or the patient is so exhausted that they can no longer move enough air to even create a wheeze. This is a medical emergency indicating _________?
impending respiratory arrest.
If a person with CF develops hyponatremic dehydration what is the treatment?
Aggressive sodium and fluid replacement during exertion
This compensatory hematologic laboratory finding is frequently monitored in chronic COPD due to prolonged systemic hypoxemia.
A) Thrombocytopenia with elevated bleeding times
B) Elevated hematocrit and hemoglobin (polycythemia)
C) Leukopenia with a left shift in differential white blood cells
D) Decreased red blood cell count with microcytic indices
Elevated hematocrit and hemoglobin (polycythemia)
This crucial post-administration hygiene step prevents oral candidiasis (thrush) when a patient uses an inhaled corticosteroid.
A) Brushing the tongue with a stiff bristle toothbrush every morning
B) Swallowing a large glass of citrus juice to alter ph balance
C) Rinsing the mouth and gargling with water immediately after use
D) Applying an over-the-counter antifungal mouthwash prior to inhalation
Rinsing the mouth and gargling with water immediately after use
This specific diagnostic value obtained via pilocarpine iontophoresis confirms a clinical diagnosis of cystic fibrosis in children.
A) A sweat chloride concentration greater than 60 mmol/L
B) A serum chloride level less than 95 mEq/L
C) A total sweat sodium reading below 10 mmol/L
D) An arterial blood gas bicarbonate level over 40 mEq/L
A sweat chloride concentration greater than 60 mmol/L
The right ventricle of the heart is built to pump blood under low pressure. Forced to push against high pulmonary pressures, it hypertrophies (enlarges) and eventually fails. This right-sided heart failure caused by lung disease is called ________ .
cor pulmonale
which is why you see systemic backups like jugular venous distention (JVD) and peripheral leg edema.
This intravenous medication is a methylxanthine derivative used as a last-resort continuous infusion for refractory status asthmaticus. It requires strict therapeutic drug monitoring because its narrow therapeutic index can cause fatal cardiac arrhythmias and seizures at toxic blood levels.
Intravenous Aminophylline / Theophylline
This clinical complication of late-stage COPD manifests as jugular venous distention, peripheral edema, and an accentuated pulmonic heart sound.
A) Left ventricular hypertrophy
B) Metabolic alkalosis secondary to diuretic usage
C) Cor pulmonale (right-sided heart failure)
D) Aortic valve stenosis
Cor pulmonale (right-sided heart failure)
This critical physical assessment finding involves a drop in systolic blood pressure of greater than 10 mmHg during inspiration, commonly seen in severe status asthmaticus.
A) Pulsus paradoxus
B) Pulsus alternans
C) Water-hammer pulse
D) Bounding hyperkinetic pulse
Pulsus paradoxus
This specific electrolyte monitoring and fluid recommendation is critical for a patient with cystic fibrosis during periods of strenuous exercise or hot weather.
A) Strict fluid and sodium restriction to prevent circulatory fluid overload
B) Increasing salt and fluid intake to prevent hyponatremic dehydration
C) Eliminating all dietary sodium to decrease thick bronchial mucus viscosity
D) Replacing water exclusively with salt-free electrolyte-free ice chips
Increasing salt and fluid intake to prevent hyponatremic dehydration
In Status asthmaticus the left ventricle is physically compressed and fighting negative thoracic pressure, its stroke volume drops during inhalation. This causes a noticeable drop in systemic systolic blood pressure (>10 mmHg) during inspiration known as _______.
pulsus paradoxus
When kidneys sense prolonged low oxygen, they secrete the hormone erythropoietin (EPO). This stimulates the bone marrow to accelerate the production of red blood cells (RBCs).
This results in ___________elevating the risk of blood clots and further strains the heart.
elevated hemoglobin and hematocrit (secondary polycythemia)