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1.5 CE Test Hours

Managing Stable COPD

An Evidence-Based Approach

Contrada, Emily

AJN The American Journal of Nursing: September 2018 - Volume 118 - Issue 9 - p 48,49
doi: 10.1097/01.NAJ.0000544951.50463.a8
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Managing Stable COPD: An Evidence-Based Approach


To provide information about recent guideline changes related to chronic obstructive pulmonary disease (COPD) and their application to clinical practice.

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After completing this continuing education activity, you should be able to

  • outline strategies for the assessment and diagnosis of COPD.
  • explain key teaching points for patients with COPD.
  • list pharmacologic and nonpharmacologic interventions for COPD.
  1. Which of the following are among the predominant types of cells in chronic obstructive pulmonary disease (COPD)?
    1. histamine
    2. mast cells
    3. neutrophils
  2. Which of the following is the most common risk factor for COPD?
    1. male sex
    2. tobacco smoking
    3. occupational exposure to chemicals
  3. Clinical manifestations of COPD include progressive dyspnea that becomes worse with
    1. exercise.
    2. cold exposure.
    3. deep inhalation.
  4. With spirometry, irreversible obstructive lung disease is indicated when the postbronchodilator ratio of forced expiratory volume in the first second (FEV1) to forced vital capacity is less than
    1. 70%.
    2. 75%.
    3. 80%.
  5. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) report, a FEV1 of 30% to 49% of predicted normal value classifies the patient as GOLD
    1. 2.
    2. 3.
    3. 4.
  6. A low symptom burden is indicated by a COPD Assessment Test score of less than
    1. 10.
    2. 20.
    3. 30.
  7. In the “5 A's” model to empower patients to quit smoking, one of the “A's” is
    1. accept.
    2. adhere.
    3. arrange.
  8. A systematic review of studies evaluating the use of dry powder inhalers by patients with asthma or COPD found that most patients did not use their inhalers appropriately by failing to
    1. inhale in short puffs.
    2. exhale before inhalation.
    3. exhale quickly after inhalation.
  9. Adverse effects of β-2 agonists include
    1. hyperkalemia.
    2. sinus bradycardia.
    3. exaggerated somatic tremor.
  10. The most common adverse effect of antimuscarinics is
    1. xerostomia.
    2. myalgia.
    3. nausea.
  11. A common adverse effect of inhaled corticosteroids is
    1. diplopia.
    2. palpitations.
    3. oral candidiasis.
  12. Phosphodiesterase-4 inhibitors should be prescribed only in patients with a FEV1 below 50% of predicted normal value and chronic bronchitis, in addition to being in GOLD Group
    1. B.
    2. C.
    3. D.
  13. Patients in GOLD Group D should start COPD therapy with a
    1. methylxanthine.
    2. short-acting muscarinic antagonist.
    3. long-acting β-2 agonist and a long-acting muscarinic antagonist.
  14. Pulmonary rehabilitation is defined as exercise training for at least how many weeks?
    1. 2
    2. 4
    3. 6
  15. Oxygen therapy delivered for at least 15 hours per day has been shown to improve survival rates among patients who have chronic respiratory failure and
    1. pneumonia.
    2. coronary artery disease.
    3. severe resting hypoxemia.
  16. Compared with a hospital readmission rate at 180 days of 75% for patients not discharged with noninvasive positive-pressure ventilation (NPPV), the rate for those discharged with NPPV was only
    1. 39.7%.
    2. 48.3%.
    3. 56.2%.
  17. In patients with severe COPD and no contraindications, which of the following may be an option?
    1. bullectomy
    2. lung transplant
    3. lung volume reduction surgery
  18. Divo and colleagues found that the 12 comorbidities most strongly associated with increased risk of death in COPD included
    1. atrial fibrillation.
    2. colorectal cancer.
    3. thyroid disease.
  19. To decrease the sensation of breathlessness in patients with dyspnea, research supports
    1. avoiding the use of opioids.
    2. using oxygen only as a last resort.
    3. the use of a fan blowing in the patient's face.
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