Take the Test

1. Chronic obstructive pulmonary disease is characterized by:

• a. Greater absorption of oxygen by the lungs.
• b. Airflow obstruction in the lungs.
• c. Acute lung injury.
• d. Increased lung reserve capacity.

2. A 70-year-old female patient states that she quit smoking five years ago after having smoked regularly for many years. Which statement likely best explains why she is experiencing greater-than-normal difficulty breathing for her age?

• a. The patient’s advanced age is compromising her breathing ability.
• b. The presence of a respiratory infection could be causing symptoms of chronic obstructive pulmonary disease.
• c. The patient is probably still smoking, just not as much as before.
• d. The course of chronic obstructive pulmonary disease is irreversible, with symptoms sometimes delayed until later in life.

3. In the breathing of a patient with normal lungs:

• a. The lungs are completely empty after exhalation.
• b. Some air is left inside the lungs after exhalation.
• c. Saliva and postnasal drip move down into the airways.
• d. The airways of the lungs maintain a dry environment.

4. The emphysema form of COPD is characterized by:

• a. Destruction of alveoli, decreased lung tissue elasticity, and hyperinflated lungs.
• b. Chronic cough, excess sputum production, and increased lung area for gas exchange.
• c. Development of compensatory pulmonary capillaries and alveoli.
• d. Destruction of proximal airway structures and deflated lungs.

5. When a patient with asthma also smokes cigarettes, they are:

• a. Protected somewhat from developing chronic obstructive pulmonary disease.
• b. Less likely than a nonsmoker to develop chronic obstructive pulmonary disease.
• c. More likely than a nonsmoker to develop chronic obstructive pulmonary disease.
• d. At equal risk with a nonsmoker to develop chronic obstructive pulmonary disease.

6. A male patient with chronic emphysema asks the clinician why he becomes so tired “just sitting and taking deep breaths.” The clinician knows the patient has understood the explanation of the physiology leading to his clinical symptoms when the patient responds:

• a. “I’m going to have to take it easy; I must be exerting myself too much.”
• b. “I guess my lungs are deflated all the time and there’s no room for air in there.”
• c. “My lungs are working so hard trying to get the air in and out.”
• d. “Maybe I need some iron pills.”

7. Which statement best describes coughing associated with COPD?

• a. It typically develops later than dyspnea due to COPD.
• b. It is usually worse toward the end of the day.
• c. It is the most common symptom found in patients with early COPD.
• d. It is the symptom that most often prompts the individual’s visit to a healthcare provider.

8. Patients with emphysematous chronic obstructive pulmonary disease tend to sit in a tripod position in order to:

• a. Concentrate on what is being said to them.
• b. Expectorate mucus or phlegm.
• c. Maintain a neutral sitting position.
• d. Expand the chest to breathe more easily.

9. When educating patients with COPD regarding energy conservation, a clinician encourages patients to:

• a. Finish tasks quickly so that they can rest.
• b. Stand while performing tasks in order to improve strength.
• c. Rest before and after activities, as needed.
• d. Avoid showering or bathing in the evening.

10. Nicotine replacement therapy is effective in helping patients to stop smoking by:

• a. Creating a placebo effect.
• b. Easing the withdrawal symptoms of nicotine.
• c. Providing an alternative product that must be taken long-term.
• d. Replacing an addiction to cigarettes with an addiction to pure nicotine.

11. When teaching a patient pursed-lip breathing, the clinician states:

• a. “Breathe in for twice as long as breathing out.”
• b. “Inhale through the mouth with pursed lips, creating a whistling noise.”
• c. “Breathe out for the count of two.”
• d. “Exhale slowly and gently through pursed lips while counting to four.”

12. Which pharmacologic therapy is used most regularly in patients with COPD?

• a. Bronchodilators
• b. Corticosteroids
• c. Phosphodieserase inhibitors
• d. Mucolytic agents

13. Which is a correct statement regarding oxygen therapy for patients with COPD?

• a. Supplemental oxygen is not routinely prescribed for patients with an oxygenation saturation greater than 89%.
• b. Supplemental oxygen does not improve survival rates in patients with COPD.
• c. Long-term oxygen therapy is not recommended for patients with pulmonary hypertension, peripheral edema, or polycythemia.
• d. Oxygen therapy is inexpensive and therefore recommended for all COPD patients.

14. Which is a correct statement regarding lung volume reduction surgery?

• a. The surgery is not performed on patients over the age of 55.
• b. Patients typically cannot exercise as much after the surgery.
• c. The surgery involves removing a lung to improve airflow.
• d. Air leakage from the lungs into the chest is a major complication.

15. Which is a common cause of an acute exacerbation of COPD?

• a. Myocardial infarction
• b. Rare medical conditions
• c. Nausea and vomiting
• d. Respiratory infection