Chapter 29- Obstructive Pulmonary Diseases

Question 1

The nurse in the emergency department receives arterial blood gas results for four
recently admitted patients with obstructive pulmonary disease. Which patient will require
the most rapid action by the nurse?
a. 22-year-old with ABG results: pH 7.28, PaCO2 60 mm Hg, and PaO2 58 mm Hg
b. 34-year-old with ABG results: pH 7.48, PaCO2 30 mm Hg, and PaO2 65 mm Hg
c. 45-year-old with ABG results: pH 7.34, PaCO2 33 mm Hg, and PaO2 80 mm Hg
d. 65-year-old with ABG results: pH 7.31, PaCO2 58 mm Hg, and PaO2 64 mm Hg

Answer 1

22-year-old with ABG results: pH 7.28,
PaCO2 60 mm Hg, and PaO2 58 mm
Hg

Question 2

The nurse is caring for a patient with cor pulmonale. The nurse should monitor
the patient for which expected finding?
a. Peripheral edema
b. Elevated temperature
c. Clubbing of the fingers
d. Complaints of chest pain

Answer 2

Peripheral edema

Question 3

A male patient with COPD becomes dyspneic at rest. His baseline blood gas results are PaO2 70 mm Hg,
PaCO2 52 mm Hg, and pH 7.34. What updated patient assessment requires the nurse’s priority
intervention?
a) Arterial pH 7.26
b) PaCO2 50 mm Hg
c) Patient in tripod position
d) Increased sputum expectoration

Answer 3

a) Arterial pH 7.26
The patient’s pH shows acidosis that supports an exacerbation of COPD along
with the worsening dyspnea. The PaCO2 has improved from baseline, the tripod
position helps the patient’s breathing, and the increase in sputum expectoration
will improve the patient’s ventilation.

Question 4

Nursing assessment findings of jugular venous distention and pedal edema would be indicative of what
complication of chronic obstructive pulmonary disease (COPD)?
a) Acute respiratory failure
b) Secondary respiratory infection
c) Fluid volume excess resulting from cor pulmonale
d) Pulmonary edema caused by left-sided heart failure

Answer 4

c) Fluid volume excess resulting from cor pulmonale
Cor pulmonale is a right-sided heart failure caused by resistance to right
ventricular outflow resulting from lung disease. With failure of the right
ventricle, the blood emptying into the right atrium and ventricle would be
slowed, leading to jugular venous distention and pedal edema.

Question 5

A patient has been receiving oxygen per nasal cannula while hospitalized for COPD. The patient asks the
nurse whether oxygen use will be needed at home. What is the most appropriate response by the nurse?
a) “Long-term home oxygen therapy should be used to prevent respiratory failure.”
b) “Oxygen will not be needed until or unless you are in the terminal stages of this disease.”
c) “Long-term home oxygen therapy should be used to prevent heart problems related to COPD.”
d) “You will not need oxygen until your oxygen saturation drops to 88% and you have symptoms of
hypoxia.”

Answer 5

d) “You will not need oxygen until your oxygen saturation drops to 88% and you have
symptoms of hypoxia.”
Long-term oxygen therapy in the home will not be considered until the oxygen saturation
is less than or equal to 88% and the patient has signs of tissue hypoxia, such as cor
pulmonale, erythrocytosis, or impaired mental status. PaO2 less than 55 mm Hg will also
allow home oxygen therapy to be considered.