COPD Practice Questions PDF

### COPD Practice: **1. Pathophysiology of COPD** A patient with COPD has chronic bronchitis. Which clinical feature is most associated with this condition?\ A. Barrel chest\ B. Persistent productive cough\ C. Weight loss\ D. Dyspnea at rest **Answer:** B. Persistent productive cough\ **Rationale:...

### COPD Practice: **1. Pathophysiology of COPD** A patient with COPD has chronic bronchitis. Which clinical feature is most associated with this condition?\ A. Barrel chest\ B. Persistent productive cough\ C. Weight loss\ D. Dyspnea at rest **Answer:** B. Persistent productive cough\ **Rationale:** Chronic bronchitis is characterized by excessive mucus production, leading to a persistent productive cough lasting at least three months for two consecutive years​. **2. Clinical Manifestations** What symptom is most indicative of emphysema in a COPD patient?\ A. Cyanosis\ B. Pursed-lip breathing\ C. Large amounts of sputum\ D. Loud rhonchi **Answer:** B. Pursed-lip breathing\ **Rationale:** Pursed-lip breathing is a compensatory mechanism in emphysema to promote expiration and reduce air trapping​. **3. Risk Factors** Which is the primary risk factor for developing COPD?\ A. Alpha-1 antitrypsin deficiency\ B. Exposure to air pollution\ C. Cigarette smoking\ D. Occupational irritants **Answer:** C. Cigarette smoking\ **Rationale:** Smoking is the leading cause of COPD, accounting for approximately 80% of cases​. **4. Diagnostic Testing** Which pulmonary function test (PFT) finding is consistent with COPD?\ A. Increased forced expiratory volume (FEV1)\ B. Decreased residual volume (RV)\ C. Decreased FEV1/FVC ratio\ D. Normal forced vital capacity (FVC) **Answer:** C. Decreased FEV1/FVC ratio\ **Rationale:** COPD is diagnosed with a reduced FEV1/FVC ratio, indicating obstructive airflow limitation​. **5. Pharmacologic Therapy** A nurse administers a beta-2 adrenergic agonist to a patient with COPD. What is the primary therapeutic action of this drug?\ A. Reduce inflammation in the lungs\ B. Decrease mucus production\ C. Relax bronchial smooth muscles\ D. Thin bronchial secretions **Answer:** C. Relax bronchial smooth muscles\ **Rationale:** Beta-2 agonists dilate bronchial smooth muscles, relieving bronchospasm​. **6. Nursing Education** What should a nurse include when teaching a patient about the use of an MDI (metered-dose inhaler)?\ A. Exhale deeply after inhaling the medication\ B. Hold breath for 5--10 seconds after inhalation\ C. Use a spacer to reduce drug delivery\ D. Shake the inhaler only if it contains steroids **Answer:** B. Hold breath for 5--10 seconds after inhalation\ **Rationale:** Holding breath allows better absorption of medication in the lungs​. **7. Side Effects of Beta-2 Agonists** A patient taking albuterol reports insomnia and nervousness. How should the nurse respond?\ A. \"These are expected side effects.\"\ B. \"Stop taking the medication immediately.\"\ C. \"Increase your dose to offset these effects.\"\ D. \"Take the medication before bedtime.\" **Answer:** A. \"These are expected side effects.\"\ **Rationale:** Insomnia and nervousness are common side effects of beta-2 adrenergic agonists​. **8. Nonpharmacologic Management** Which intervention helps to loosen secretions in a COPD patient?\ A. Using sedatives\ B. Postural drainage\ C. Administering anticholinergics\ D. Restricting fluid intake **Answer:** B. Postural drainage\ **Rationale:** Postural drainage uses gravity to remove secretions from the lungs​. **9. Oxygen Therapy** Why must oxygen therapy be used cautiously in COPD patients with chronic hypercarbia?\ A. Oxygen may dry mucous membranes.\ B. It can suppress their hypoxic drive to breathe.\ C. It may reduce exercise tolerance.\ D. Oxygen can lead to infection. **Answer:** B. It can suppress their hypoxic drive to breathe.\ **Rationale:** COPD patients often rely on hypoxia to stimulate respiration due to chronic CO2 retention​. **10. COPD Exacerbation Management** Which is the most common cause of COPD exacerbations?\ A. Smoking\ B. Viral or bacterial infections\ C. Overexertion\ D. Dehydration **Answer:** B. Viral or bacterial infections\ **Rationale:** Infections frequently trigger COPD exacerbations​. **11. COPD Nursing Actions** Which nursing action helps promote airway clearance in a patient with COPD?\ A. Encourage fluid intake of more than 2000 mL/day.\ B. Administer sedatives as needed for anxiety.\ C. Restrict physical activity to conserve energy.\ D. Position the patient flat on their back to promote drainage. **Answer:** A. Encourage fluid intake of more than 2000 mL/day.\ **Rationale:** Adequate hydration helps thin mucus, making it easier to expectorate​. **12. Clinical Manifestations** What is a hallmark sign of chronic bronchitis in COPD?\ A. Tachypnea\ B. Cyanosis\ C. Barrel chest\ D. Hyperinflation of the lungs **Answer:** B. Cyanosis\ **Rationale:** Chronic bronchitis is often associated with cyanosis due to inadequate oxygenation, giving patients a bluish skin tone​. **13. Pharmacologic Therapy** A patient is prescribed tiotropium bromide for COPD. What class of medication is this?\ A. Beta-2 adrenergic agonist\ B. Anticholinergic bronchodilator\ C. Corticosteroid\ D. Mucolytic agent **Answer:** B. Anticholinergic bronchodilator\ **Rationale:** Tiotropium bromide (Spiriva) is an anticholinergic that relaxes bronchial muscles and reduces mucus production​. **14. Nonpharmacologic Therapy** What dietary advice should the nurse give to a patient with COPD?\ A. Follow a low-protein diet.\ B. Eat large meals three times a day.\ C. Rest before meals to conserve energy.\ D. Avoid eating foods high in calories. **Answer:** C. Rest before meals to conserve energy.\ **Rationale:** Resting before meals reduces fatigue and improves the patient's ability to eat adequately​. **15. Smoking Cessation** What benefit can a COPD patient expect from smoking cessation after diagnosis?\ A. Immediate restoration of lung function\ B. Prevention of further lung damage\ C. Elimination of dyspnea\ D. Permanent reversal of all symptoms **Answer:** B. Prevention of further lung damage\ **Rationale:** Smoking cessation can slow disease progression and prevent additional damage​. **16. Oxygen Therapy** Which statement indicates a need for further teaching about home oxygen use?\ A. \"I will store oxygen tanks upright and secure.\"\ B. \"I can use petroleum jelly for dry nasal passages.\"\ C. \"I will avoid open flames while using oxygen.\"\ D. \"I can use an oxygen concentrator for continuous therapy.\" **Answer:** B. \"I can use petroleum jelly for dry nasal passages.\"\ **Rationale:** Petroleum-based products are flammable and should not be used with oxygen therapy​. **17. Risk Factors** Which factor is a modifiable risk for developing COPD?\ A. Genetic predisposition\ B. Aging\ C. Cigarette smoking\ D. Alpha-1 antitrypsin deficiency **Answer:** C. Cigarette smoking\ **Rationale:** Smoking is a modifiable risk factor and the leading cause of COPD​. **18. Pursed-Lip Breathing** What is the primary purpose of pursed-lip breathing in COPD patients?\ A. Increase oxygen intake.\ B. Decrease respiratory rate.\ C. Prevent airway collapse during expiration.\ D. Improve diaphragmatic movement. **Answer:** C. Prevent airway collapse during expiration.\ **Rationale:** Pursed-lip breathing prolongs exhalation and reduces air trapping​. **19. Activity Management** A nurse advises a patient with COPD to pace activities. What is the primary goal of this intervention?\ A. Improve lung function.\ B. Reduce the need for supplemental oxygen.\ C. Decrease fatigue.\ D. Prevent weight gain. **Answer:** C. Decrease fatigue.\ **Rationale:** Energy conservation strategies help reduce fatigue caused by dyspnea and increased work of breathing​. **20. Corticosteroid Use** A patient taking inhaled corticosteroids for COPD should be taught to:\ A. Use the inhaler only during exacerbations.\ B. Taper the medication gradually.\ C. Rinse their mouth after each use.\ D. Take the medication before meals. **Answer:** C. Rinse their mouth after each use.\ **Rationale:** Rinsing prevents oral thrush, a potential side effect of inhaled corticosteroids​. **21. Anxiety in COPD** Why is anxiety common in COPD patients?\ A. The disease is progressive and irreversible.\ B. It is a side effect of bronchodilators.\ C. Corticosteroids induce mood changes.\ D. Oxygen therapy limits mobility. **Answer:** A. The disease is progressive and irreversible.\ **Rationale:** The chronic nature and limitations of COPD contribute to anxiety​. **22. Surgical Interventions** Which surgical option is considered for severe COPD?\ A. Lung volume reduction surgery\ B. Coronary artery bypass grafting\ C. Lobectomy\ D. Tracheostomy **Answer:** A. Lung volume reduction surgery\ **Rationale:** This procedure removes diseased lung tissue to improve respiratory function​. **23. COPD Diet** What type of diet should a nurse recommend for a COPD patient?\ A. Low-calorie, low-protein diet\ B. High-calorie, high-protein diet\ C. High-fiber, low-fat diet\ D. Low-sodium, high-carbohydrate diet **Answer:** B. High-calorie, high-protein diet\ **Rationale:** Increased caloric intake compensates for the high energy demand of breathing​. **24. COPD and Infection** How can COPD patients prevent respiratory infections?\ A. Avoid influenza and pneumonia vaccines.\ B. Use antibiotics daily as a preventive measure.\ C. Avoid crowds and sick contacts.\ D. Increase use of corticosteroids during flu season. **Answer:** C. Avoid crowds and sick contacts.\ **Rationale:** Reducing exposure to infectious agents minimizes the risk of respiratory infections​. **25. Medication Monitoring** What is the therapeutic range for theophylline in COPD management?\ A. 2--5 mcg/mL\ B. 5--10 mcg/mL\ C. 10--20 mcg/mL\ D. 20--30 mcg/mL **Answer:** C. 10--20 mcg/mL\ **Rationale:** Monitoring ensures efficacy and prevents toxicity​. **26. COPD Exacerbations** Which symptom indicates a COPD exacerbation?\ A. Reduced sputum production\ B. Persistent chest pain\ C. Increased dyspnea\ D. Elevated blood pressure **Answer:** C. Increased dyspnea\ **Rationale:** Worsening dyspnea is a hallmark of COPD exacerbations​. **27. Patient Positioning** What is the best position for a patient experiencing dyspnea?\ A. Supine\ B. High-Fowler\'s\ C. Lateral\ D. Prone **Answer:** B. High-Fowler\'s\ **Rationale:** High-Fowler's position maximizes lung expansion​. **28. Mucolytic Therapy** What is the primary purpose of administering mucolytics in COPD?\ A. Reduce inflammation\ B. Thin and loosen mucus\ C. Dilate the bronchioles\ D. Suppress coughing **Answer:** B. Thin and loosen mucus\ **Rationale:** Mucolytics facilitate expectoration of thick secretions​. **29. Monitoring ABGs** What arterial blood gas (ABG) finding is consistent with COPD?\ A. Respiratory acidosis\ B. Metabolic alkalosis\ C. Normal pH\ D. Low PaCO2 **Answer:** A. Respiratory acidosis\ **Rationale:** COPD often causes CO2 retention, leading to respiratory acidosis​. **30. Long-Term Goals** What is a realistic long-term goal for a patient with COPD?\ A. Completely reverse lung damage.\ B. Maintain oxygen saturation above 90%.\ C. Eliminate dyspnea.\ D. Avoid all infections. **Answer:** B. Maintain oxygen saturation above 90%.\ **Rationale:** This goal reflects optimal oxygenation while acknowledging the chronic nature of COPD​.