Which long-term resident is most likely to be exhibiting the signs and symptoms of chronic obstructive pulmonary disease (COPD)?
A 79 year old lifetime smoker who is complaining of shortness of breath and pain on deep inspiration
An 88 year old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke
An 81 year old smoker who has increased exercise intolerance, a fever and increased white blood cells
An 81 year old male who has a productive cough and recurrent respiratory infections
The Correct Answer is A
A. A 79-year-old lifetime smoker who is complaining of shortness of breath and pain on deep inspiration: Chronic obstructive pulmonary disease (COPD) is most commonly seen in individuals with a significant smoking history. Progressive shortness of breath is a hallmark symptom of COPD, resulting from chronic airway inflammation and airflow limitation. While pain on deep inspiration is not a classic COPD symptom, it could indicate pleuritic involvement or hyperinflation-related chest discomfort.
B. An 88-year-old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke: Acute shortness of breath and airway constriction in response to tobacco smoke suggests an asthma-like reaction rather than COPD. COPD symptoms tend to be persistent and progressive rather than episodic.
C. An 81-year-old smoker who has increased exercise intolerance, a fever, and increased white blood cells: Fever and increased white blood cells indicate an acute infection rather than chronic lung disease. While COPD exacerbations can cause worsening symptoms, an isolated fever and elevated white blood cells suggest pneumonia or another infectious process rather than COPD alone.
D. An 81-year-old male who has a productive cough and recurrent respiratory infections: A productive cough and recurrent respiratory infections are common in chronic bronchitis, a component of COPD. However, this presentation alone is not specific to COPD, as other conditions, such as bronchiectasis, can also cause these symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E"]
Explanation
A. Expecting copious amounts of frothy, pink sputum: This symptom is typically associated with left-sided heart failure or pulmonary edema, where fluid accumulates in the lungs, leading to the production of frothy, pink sputum. It is not a classic manifestation of right-sided heart failure.
B. Fine crackles throughout both lung fields: Fine crackles are more indicative of left-sided heart failure due to fluid accumulation in the lungs (pulmonary congestion). In right-sided heart failure, the primary issues relate more to systemic congestion rather than pulmonary congestion.
C. +pitting edema in lower extremities: Right-sided heart failure often leads to fluid retention and peripheral edema due to increased venous pressure. Pitting edema in the lower extremities is a common clinical manifestation in patients with cor pulmonale and right-sided heart failure.
D. Altered level of consciousness: This can occur due to decreased cardiac output and resulting reduced cerebral perfusion. In right-sided heart failure, especially in advanced stages, fluid overload can lead to increased intracranial pressure, contributing to altered mental status.
E. Jugular vein distention: Jugular vein distention is a classic sign of right-sided heart failure. Increased pressure in the right atrium due to fluid overload results in distended neck veins, indicating elevated venous pressure.
Correct Answer is B
Explanation
A. Septal: Septal cardiomyopathy typically refers to abnormalities in the interventricular septum and does not specifically address the rigidity and noncompliance of the myocardium that affects diastolic filling.
B. Restrictive: Restrictive cardiomyopathy is characterized by a rigid and noncompliant myocardium that impedes ventricular filling during diastole. This results in elevated pressures in the ventricles and may lead to heart failure symptoms due to poor filling capacity.
C. Infiltrative: Infiltrative cardiomyopathy involves the deposition of abnormal substances (such as amyloid or sarcoid) within the myocardial tissue, which can lead to stiffness. While this may contribute to restrictive physiology, "restrictive" is the more precise term for the condition described.
D. Hypertrophic: Hypertrophic cardiomyopathy is characterized by an abnormal thickening of the heart muscle, particularly the left ventricle. While this condition can affect diastolic filling, it is primarily due to muscle hypertrophy rather than rigidity and noncompliance of the myocardium.
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