INSTRUCTIONS Breathing new life into COPD management
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Breathing new life into COPD management
GENERAL PURPOSE: To update the professional nurse with current guidelines for care of patients with COPD. LEARNING OBJECTIVES: After reading this article and taking this test, you'll be able to: 1. Describe the pathophysiology and risk factors associated with COPD. 2. Identify effective approaches for managing COPD.
1. Which term isn't included in the GOLD guidelines for COPD?
2. Which condition is associated with alveolar destruction?
a. obstructive bronchiolitis
c. chronic bronchitis
3. Structural changes associated with COPD include
a. increased bronchial goblet cells.
b. decreased alveolar macrophages.
4. Chronic airway inflammation can lead to
a. pulmonary vasodilation.
b. inspiratory airflow obstruction.
c. pulmonary hypertension.
5. Risk factors for COPD include all of the following except
b. air pollution.
c. glucose-6 phosphate dehydrogenase deficiency.
6. Which statement about alpha1 antitrypsin is correct?
a. It's a deficiency that's a risk factor for COPD.
b. It's an inflammatory cytokine.
c. It's primarily produced in the lungs.
7. Carbon monoxide combines with hemoglobin to form
8. The maximal amount of air that can be rapidly and forcefully exhaled after maximal inhalation is
b. tidal volume.
9. A normal FEV1/FVC ratio is greater than or equal to
a. 50% of the predicted value.
b. 60% of the predicted value.
c. 70% of the predicted value.
10. An approach clinicians should use during every patient encounter to identify tobacco users and encourage them to quit is the
a. 5 A's.
b. STAR quit plan.
c. 5 R's.
11. The first step in the plan to help smokers who don't want to quit to stop smoking is to identify the
a. rewards of quitting.
b. roadblocks to quitting.
c. relevance of quitting to the patient.
12. What medications are central to symptom management in COPD?
a. mast cell stabilizers
13. Ipratropium is a short-acting
14. Which statement about adverse reactions to beta2-agonists is correct?
a. They may cause sinus tachycardia.
b. Younger patients have a higher risk of adverse reactions.
c. Oral formulations produce fewer adverse reactions.
15. What best describes theophylline use in patients with COPD?
a. It's currently a mainstay of management.
b. It's typically administered by inhalation.
c. It has a narrow therapeutic window.
16. Glucocorticosteroids for managing patients with COPD
a. may decrease the risk of pneumonia when given by inhalation.
b. are particularly effective when given orally.
c. may induce a steroid myopathy with chronic oral use.
17. The goal of oxygen therapy for COPD is to
a. achieve an Sao2 of at least 90%.
b. reverse the disease process.
c. forestall progression of the disease to stage IV.
18. Which treatment improves the elastic recoil of functional lung tissue?
a. lung volume reduction surgery
b. oxygen therapy
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