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Chapter 89: Dyspnea Buttaro: Primary Care: A Collaborative Practice, 6th Edition
from TEST BANK; Buttaro: Primary Care Interprofessional Collaborative Practice 6TH EDITION. All Chapters
by StudyGuide
Multiple Choice
1. A young adult patient without a previous history of lung disease has an increased respiratory rate and reports a feeling of “not getting enough air.” The provider auscultates clear breath sounds and notes no signs of increased respiratory effort. Which diagnostic test will the provider perform initially?
a. Chest radiograph b. Complete blood count c. Computerized tomography d. Spirometry
ANS: B a. Arterial blood gases b. Blood cultures c. Spirometry d. Ventilation/perfusion scan
This patient has no signs indicating lung disease but does exhibit signs of hypoxia. A CBC would evaluate for anemia, which is a more common cause of hypoxia in otherwise healthy adults. Chest radiography is used to evaluate infectious causes. CT is used if interstitial lung disease is suspected. Spirometry is useful to diagnose asthma and COPD.
2. A patient reports shortness of breath with activity and exhibits increased work of breathing with prolonged expirations. Which diagnostic test will the provider order to confirm a diagnosis in this patient?
ANS: C
NURSINGTB.COM a. Anxiolytic drugs b. Breathing exercises c. Opioid medications d. Supplemental oxygen
The patient has signs of either asthma or COPD. Spirometry is essential to both the diagnosis and management of these diseases. ABGs are useful when evaluating severity of exacerbations but are not specific to these diseases. Blood cultures are drawn if pneumonia is suspected. A ventilation/perfusion scan is performed to evaluate for pulmonary thromboembolic disease.
3. An older adult patient diagnosed with chronic obstructive lung disease (COPD) is experiencing dyspnea and has an oxygen saturation of 89% on room air. The patient has no history of pulmonary hypertension or congestive heart failure. What will the provider order to help manage this patient’s dyspnea?
ANS: B
Formal pulmonary rehabilitation programs, including breathing exercises, are used to manage long-term disease such as COPD. Anxiolytics and opioids must be used cautiously because of respiratory depression side effects. Medicare does not approve oxygen supplementation unless saturations are less than 88% on room air or for patients who have pulmonary hypertension or CHF who have saturations <89%.
