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NURS 3525 - Respiratory Unit Exam Questions And Accurate
Answers 2025- 2026
Inflammation of the nasal mucosa, usually in response to some kind of allergen Allergic rhinitis Occurs in spring and fall and is caused by pollen from trees, flowers, weeds, or grasses Seasonal rhinitis Throughout the year; caused by environmental allergens such as dust mites, animal dander, cockroaches, fungi, mold Perennial rhinitis What are the classifications of rhinitis? Episodic, intermittent, & persistent Symptoms associated with occasional exposure to allergen not commonly present in usual environment Episodic rhinitis Symptoms present < 4 days/week or < 4 weeks/year Intermittent rhinitis Symptoms present > 4 days/week or > 4 weeks/year Persistent rhinitis
What are the clinical manifestations of allergic rhinitis? Sneezing, watery, itchy eyes and nose, ↓ sense of smell, and thin, watery nasal discharge that leads to 𝖳 mucus production and congestion What are the physical assessments of allergic rhinitis? Nasal turbinates appear pale, boggy, swollen What are the clinical manifestations of chronic exposure to allergens? HA, stuffy nose, nasal congestion, 𝖳 sinus pressure. Nasal polyps, postnasal drip results in cough + hoarseness What is the nonpharmacologic management of allergic rhinitis? Avoid triggers of allergic reactions What is the pharmacologic goal for allergic rhinitis? ↓ inflammation, reduce nasal symptoms, minimize complications, maximize QOL What are examples of oral drugs for allergic rhinitis? H1-antihistamines (Benadryl, Claritin, allegra), decongestants (pseudoephedrine, afrin), leukotriene receptor antagonists (LTRAs) What are some examples of intranasal medications for allergic rhinitis? Antihistamines, anticholinergics, corticosteroids, mast-cell stabilizers, decongestants What are some examples of immunotherapy for allergic rhinitis? Allergy shots
How do you relieve URI symptoms? Rest, fluids, antipyretics, analgesics, antihistamines What are the possible complications of URIs? Acute bronchitis, sinusitis, otitis media, tonsilitis, pneumonia. Antibiotics do not treat viruses What do we look for during URIs to prevent complications? 𝖳 fever, swollen glands, severe sinus + ear pain, worsening symptoms What is the etiology of influenza? Viral. Classified in 4 serotypes A,B,C,D. A/B significant to humans, A most common + virulent virus. How is influenza communicable? B/t humans through infected droplets, inhalation of aerosolized particles, and in a lesser extent through direct contact with contaminated surfaces What are the clinical manifestations of influenza? Abrupt onset, chills, fever, generalized myalgia, HA, cough, sore throat, fatigue What are the manifestations of the common cold vs. influenza? Gradual vs. abrupt onset, no fever vs. fever, no HA vs. HA, slight vs. severe myalgia, occasional vs. usual fatigue What are the complications of influenza? Bronchitis, pneumonia, acute respiratory failure and acute respiratory distress
syndrome (ARDS) What diagnostics are used in a Pt. w/influenza? Cultures done via nose + throat can identify causative agents. Rapid test screens for A/B, can get false positive What is the management plan for influenza? Prevention: flu vaccine. + relief of symptoms Protects against 3 different types of flu virus, (2-type A, 1 - type B) Inactivated flu vaccine - Trivalent Protects against 4 different types of flu virus, (2-type A, 2 - type B) Inactivated flu vaccine - Quadrivalent Given by injection, approved for people >6 months, do not give to anyone with serious allergy or reaction to previous vaccine, Guillain-Barre syndrome. Most common side effects: reactions to the injection site such as pain, redness, swelling Inactivated flu vaccine Live-attenuated flu vaccine Made from weakened influenza virus, given as intranasal into both nostrils, approved for healthy people ages 2 - 49, should not be used in pregnant woman or woman who could become pregnant. Adverse effects are rare and may resemble mild flu with runny nose, nasal congestion, cough, HA
- Large doses may cause tachycardia and palpitations, particularly in patients with heart disease.
- Overdose in patients over 60 years may lead to CNS depression, seizure, and hallucination. 90% of nosebleeds occur in the part of the nasal cavity, they are easy to visualize, can be self-treated, and usually stops spontaneously Anterior bleeds occur more often in older adults with other health problems, since they are closer to the throat, it is hard to determine how much blood is lost, may require medical treatment Posterior What are causes of epistaxis? Trauma, low humidity, URIs, allergies, sinusitis, foreign bodies, chemical irritants, overuse of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, medications or conditions that prolong bleeding time What meds prolong bleeding time? Aspirin, NSAIDs, warfarin, other anticoagulant drug What is the Tx plan for a Pt. experiencing epistaxis?
- Place the patient in a sitting position, leaning slightly forward with head tilted forward.
- Apply direct pressure by pinching the entire soft lower part of the nose (nostrils) together for 5 to 15 minutes.
- If bleeding does not stop after 15 minutes, seek immediate medical attention. What is the treatment for anterior epistaxis?
Insert pledget-impregnated nasal tampon with anesthetic solution, and/or vasoconstrictive agent into nasal cavity, or absorbable materials Examples of the absorbable materials? Oxidized cellulose (surgical) Gelatin foam (Gelfoam) Gelatin thrombin combination (Floseal) How is posterior epistaxis managed? Packing: compressed nasal sponge, epistaxis balloons, nasal sling, arterial embolism Acute infection of the lung parenchyma Pneumonia Describe the brief pathophysiology of pneumonia Inflammatory response = neutrophil attraction, release of inflammatory mediators, accumulation of fibrinous exudates, RBCs, and bacteria. Alveoli fills with fluid + debris = consolidation/increased production of mucus = airway obstruction → decreased gas exchange. Resolution of infection: macrophages in alveoli ingest and remove debris, normal lung tissue restored, gas exchange back to normal. Acute infection of the lung in patients who have not been hospitalized or resided in ling-term care facilities within 14 days of symptom onset CAP: Community-acquired pneumonia Pneumonia occurring in a non-intubated patient which develops 48 hours or longer after admission to hospital and was not present on admission. HAP: Hospital-acquired pneumonia or nosocomial pneumonia
Diagnostic Studies for Pneumonia Chest X-ray, bronchoscopy with bronchial washings or thoracentesis. ABG, WBC count, sputum sample, blood culture, labs Displays characteristics of the infecting pathogen, may also display pleural effusion Chest X-ray for pneumonia Obtains cell and fluid samples from patients not responding to initial therapy Bronchoscopy with bronchial washings or thoracentesis for pneumonia Displays hypoxemia, hypercapnia, acidosis Arterial blood gas (ABG) for pneumonia Occurs with bacterial pneumonia (WBC > 15,000) Leukocytosis Culture and gram stain to identify organism before starting antibiotics Sputum sample for pneumonia Done for the seriously ill with pneumonia Blood cultures for pneumonia C-reactive protein (CRP), procalcitonin, interleukin 6 Labs for pneumonia What is the goal for pneumonia management?
No signs of hypoxia, normal breathing pattern, clear breath sounds, normal chest x-ray, normal WBC, no complications What do we do for a Pt with pneumonia? Provide oxygen, aid in perfusion, relieve obstruction, early mobilization, infection and nutrition control, medication to relieve cough, fever, and pain What would we monitor for with a Pt with pneumonia? Complications: sepsis, pleural effusion, pleurisy, ARF Prolonged lung disease characterized by permanent airflow limitation COPD Presence of cough and sputum production at least 3 months in each of 2 successive years Chronic bronchitis The destruction of alveoli w/o fibrosis Emphysema Previous definitions included chronic bronchitis and emphysema. Each condition features , but neither by itself is. COPD What are risk factors for COPD? Smoking, infection, asthma, air pollution, occupational chemicals and dust, aging, genetics, alpha- 1 antitrypsin deficiency Explain the brief pathophysiology of COPD Noxious particles & gases → inflammation of central airways, peripheral airway remodeling, parenchymal destruction, pulmonary vascular changes → COPD pathology
Surgical therapy for COPD Lung volume reduction surgery, bullectomy What is the management plan for a Pt diagnosed w/ COPD? Health promotion, acute care, ambulatory care, rehabilitation, activity, psychosocial, sexuality, sleep, end of life Health promotion for COPD Vaccinations, follow medication regimen, stop smoking, hand hygiene, avoid sick, exercise Acute care for COPD Monitor indications of respiratory function regularly, monitor AP, collaborate w/interprofessional team members: respiratory therapist, dietitian, physical therapist, social worker Ambulatory care for COPD Pt teaching + understanding. Teach to understand early exacerbations Rehabilitation for COPD Exercise training, smoking cessation, nutrition cancelling, more teaching Activity for COPD Conserve energy, assistive devices, alternate ADL methods, rest periods, regular exercise + strength training Psychosocial for COPD Anger, denial, depression. Encourage support groups + therapy
Sexuality for COPD ↓ dyspnea during intimacy Sleep for COPD Evaluate for sleep apnea, difficulty sleeping due to dyspnea End of life for COPD Palliative care + hospice to be considered What is the goal of care for COPD? Relief of symptoms, ability to perform ADLs, improved exercise tolerance, no COPD r/t complications, prevention of progression, improved QOL What is the clinical problem of COPD? Impaired respiratory function Activity intolerance Nutritionally compromised Ineffective coping
