ATI LPN
Introduction of Respiratory System NCLEX Questions PN Questions
Question 1 of 5
The parents of a child with asthma are learning about performing postural drainage exercises. The nurse should teach them to perform which action before performing the exercises?
Correct Answer: A
Rationale: Bronchodilator (A) before postural drainage opens airways, per document (1). Albuterol (e.g., 2 puffs) relaxes bronchi (FEVâ‚ up 15%), easing mucus drainage (50 mL). Clothes (B) or suction (D) don't prep lungs. Antibiotics (C) treat infection, not drainage. A's action 5-10 min onset optimizes CPT, unlike B's irrelevance, per ATS.
Question 2 of 5
The primary chemical stimulus for breathing is the concentration of
Correct Answer: B
Rationale: Carbon dioxide (CO₂) in the blood is the primary breathing stimulus, detected by central chemoreceptors in the medulla as H+ ions rise (from CO₂ forming carbonic acid, H₂CO₃). Elevated CO₂ (hypercapnia) increases ventilation to expel it, maintaining pH. Oxygen (O₂) influences peripheral chemoreceptors but is secondary low O₂ (hypoxia) only drives breathing if severe. Carbon monoxide binds hemoglobin but isn't a stimulus. Carbonic acid reflects CO₂ indirectly, not directly measured. CO₂'s dominance, via brainstem response, ensures homeostasis, key in respiratory control and disorders like apnea where CO₂ sensing falters.
Question 3 of 5
When developing a discharge plan to manage the care of a client with COPD, the nurse should anticipate that the client will do which of the following?
Correct Answer: A
Rationale: Clients with COPD, marked by chronic airflow limitation, easily develop infections due to impaired mucociliary clearance and weakened immunity from chronic inflammation respiratory infections often trigger exacerbations. Maintaining status (B) is a goal, not a natural outcome; COPD progresses without intervention. Reduced oxygen need (C) contradicts disease progression, as lung damage worsens hypoxia. Permanent improvement (D) is unrealistic COPD is irreversible, though manageable. Anticipating frequent infections shapes discharge planning teaching infection prevention (e.g., vaccines, hygiene) is critical to reduce hospital readmissions, a nursing priority in chronic disease management.
Question 4 of 5
A client with acute asthma showing inspiratory and expiratory wheezes and a decreased expiratory volume should be treated with which of the following classes of medication right away?
Correct Answer: B
Rationale: Bronchodilators (B), like albuterol, are the first-line treatment for acute asthma with wheezes and reduced expiratory volume. They rapidly relax bronchial smooth muscle, reversing bronchoconstriction the root of airflow limitation easing wheezing and dyspnea. Beta-blockers (A) worsen asthma, causing constriction. Inhaled (C) or oral steroids (D) reduce inflammation but act slowly, unsuitable for immediate relief used adjunctively. Wheezing reflects narrowed airways; bronchodilators open them fast, critical in acute settings to prevent hypoxia, a nursing priority over slower anti-inflammatory options.
Question 5 of 5
A 45-year-old man has smoked two packs of cigarettes per day for 20 years. For the past 4 years, he has had chronic cough with copious mucoid expectoration. During the past year, he has had multiple respiratory tract infections diagnosed as 'viral flu'. He has also developed difficulty breathing, tightness of the chest, and audible wheezing. His breathing difficulty is relieved by inhalation of B-adrenergic agonist and disappears after the chest infection has resolved. Which of the following pathologic conditions is most likely responsible for his clinical condition?
Correct Answer: C
Rationale: Chronic asthmatic bronchitis (C) fits this smoker's profile (Page 28, Ans: C). Chronic bronchitis (cough >3 months, 2 years) from smoking (40 pack-years) plus nonatopic asthma (wheezing, B-agonist relief) post-viral infections explains symptoms . AAT deficiency (A) causes panacinar emphysema, no bronchoconstriction. Centriacinar emphysema (B) lacks wheezing prominence. Cystic fibrosis (D) starts in childhood, not midlife. C's dual pathology mucus hypersecretion (100 mL/day) and hyperreactivity distinguishes it from A's genetic basis or B's pure obstruction, per document.