Chapter 88: Chronic Obstructive Pulmonary Disease

Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. Which is characteristic of obstructive bronchitis and not emphysema?

a. Damage to the alveolar wall b. Destruction of alveolar architecture c. Mild alteration in lung tissue compliance d. Mismatch of ventilation and perfusion

ANS: C a. COPD Assessment Test b. Forced expiratory time maneuver c. Lung radiograph d. Spirometry for FVC and FEV1

Obstructive bronchitis causes much less parenchymal damage than emphysema does, so there is milder alteration in lung tissue compliance. The other symptoms are characteristic of emphysema.

2. Which test is the most diagnostic for chronic obstructive pulmonary disease (COPD)?

ANS: D

Spirometry testing is the gold standard for diagnosis and assessment of COPD because it is reproducible and objective. The forced expiratory time maneuver is easy to perform in a clinic setting and is a good screening to indicate a need for confirmatory spirometry. Lung radiographs are non-specific but may indicate hyperexpansion of lungs. The COPD assessment test helps measure health status impairment in persons already diagnosed with COPD.

NURSINGTB.COM a. Ipratropium bromide b. Pirbuterol acetate c. Salmeterol xinafoate d. Theophylline

3. A patient diagnosed with chronic obstructive pulmonary disease reports daily symptoms of dyspnea and cough. Which medication will the primary health care provider prescribe?

ANS: A

Ipratropium bromide is an anticholinergic medication and is used as first-line therapy in patients with daily symptoms. Pirbuterol acetate and salmeterol xinafoate are both beta2-adrenergics and are used to relieve bronchospasm; pirbuterol is a short-term medication used for symptomatic relief and salmeterol is a long-term medication useful for reducing nocturnal symptoms. Theophylline is a third-line agent.