2 - 1 Bronchiectasis Flashcards by Neal Aaron Ente

Which structural abnormality defines bronchiectasis?
A. Irreversible dilation of bronchi with wall thickening
B. Loss of alveolar septa leading to hyperinflation
C. Fibrosis of alveolar walls causing restrictive pattern
D. Collapse of distal airways only on expiration

Correct Answer: A
Rationale: Bronchiectasis is characterized by permanent dilation of the bronchi with inflammation and wall thickening. B describes emphysema; C describes interstitial fibrosis/restrictive disease; D describes dynamic small-airway collapse, not the defining lesion of bronchiectasis.

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Which histologic change is most responsible for impaired mucociliary clearance in bronchiectasis?
A. Loss of alveolar macrophages
B. Increased surfactant production
C. Hypertrophy of pulmonary arterioles
D. Damage to ciliated epithelium and goblet cell hyperplasia

Correct Answer: D
Rationale: Damage to ciliated epithelial cells and goblet cell hyperplasia (mucus overproduction) disrupt normal mucociliary clearance. The other choices don’t directly impair the mucociliary escalator.

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Which bronchial wall component most contributes to airway rigidity vs collapsibility?
A. Pulmonary capillary bed
B. Type II pneumocytes
C. Cartilage plates in larger bronchi
D. Smooth muscle only

Correct Answer: C
Rationale: Cartilage plates in larger bronchi provide structural support and resist collapse; loss or damage can predispose to abnormal dilation. Smooth muscle affects tone but not rigid structural support; the pulmonary capillary bed and type II pneumocytes are unrelated to bronchial wall rigidity.

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In bronchiectasis, chronic infection perpetuates airway damage via which primary mechanism?
A. Autoimmune destruction of alveoli
B. Protease- and neutrophil-mediated tissue degradation
C. Formation of granulomas only
D. Recurrent pulmonary emboli

Correct Answer: B
Rationale: Chronic infection/inflammation recruits neutrophils and proteases (e.g., elastase) that damage airway walls, perpetuating dilation. Granulomas occur in specific diseases (e.g., TB, sarcoid) but are not the universal mechanism; emboli don’t cause bronchiectasis.

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Which morphological pattern is described as cystic (saccular) bronchiectasis?
A. Airways with large, ballooned, saccular dilatations forming clusters
B. Uniform narrowing of bronchioles without dilation
C. Bronchial wall thickening with small nodules
D. Mucous plugging alone with no dilation

Correct Answer: A
Rationale: Cystic (saccular) bronchiectasis shows large ballooned saccular dilations. Cylindrical and varicose patterns differ in appearance. Mucous plugs can occur but do not define the cystic morphology.

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Which blood supply predominates in the bronchial walls and is important in the pathophysiology of hemoptysis in bronchiectasis?
A. Pulmonary venous circulation
B. Lymphatic plexus only
C. Pulmonary arterial supply exclusively
D. Bronchial arterial circulation (systemic)

Correct Answer: D
Rationale: The bronchial arteries (systemic circulation) supply bronchial walls; they can become hypertrophied and tortuous in bronchiectasis, predisposing to hemoptysis. Pulmonary arteries supply alveoli for gas exchange; bronchial arterial hypertrophy is the usual bleeding source.

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Which morphologic type of bronchiectasis is most commonly associated with cystic fibrosis?
A. Cylindrical (tubular)
B. Varicose
C. Cystic (saccular)
D. Follicular

Correct Answer: C
Rationale: Cystic (saccular) bronchiectasis is typically seen in cystic fibrosis and severe disease, with large saccular dilations. Cylindrical is more common in milder forms; “follicular” is not a standard morphological classification.

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Which physiologic consequence most directly results from extensive bronchiectasis?
A. Increased alveolar surface area for diffusion
B. Reduced ventilation with local V/Q mismatch and recurrent infection
C. Systemic arterial hypovolemia
D. Decreased total lung capacity only

Correct Answer: B
Rationale: Bronchiectasis causes impaired airway clearance → mucus retention → infection and local V/Q mismatch, leading to hypoxemia in affected areas. It does not increase alveolar surface area; TLC may be variable.

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Which feature on cross-sectional imaging (CT) is a hallmark of bronchiectasis?
A. Bronchial lumen diameter larger than adjacent pulmonary artery (signet ring sign)
B. Diffuse ground-glass opacities without airway changes
C. Large pleural effusions only
D. Mosaic attenuation exclusively from emboli

Correct Answer: A
Rationale: The “signet ring” sign on CT (bronchus larger than accompanying artery) is classic for bronchiectasis. Ground-glass; pleural effusion; and mosaic attenuation have other causes.

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Which airway location is most commonly affected by non–cystic-fibrosis bronchiectasis?
A. Right middle lobe and lingula (dependent areas)
B. Upper-zone apices only
C. Trachea exclusively
D. Pulmonary veins

Correct Answer: D
Rationale: Non-CF bronchiectasis commonly involves right middle lobe and lingula due to anatomical drainage and clearance issues. Upper lobe predominance is often seen in tuberculosis/CF-related disease. Trachea and pulmonary veins are not typical primary sites.

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Which cells are primarily responsible for mucous hypersecretion in airway diseases like bronchiectasis?
A. Alveolar macrophages
B. Type I pneumocytes
C. Goblet cells and submucosal glands
D. Endothelial cells

Correct Answer: C
Rationale: Goblet cell hyperplasia and enlargement of submucosal glands lead to increased mucus production. Alveolar macrophages clear debris but do not produce mucus; type I pneumocytes participate in gas exchange.

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Which structural abnormality explains airway plugging and recurrent infections in bronchiectasis?
A. Mucus impaction with impaired clearance
B. Pulmonary emboli occluding arteries
C. Absolute increase in ciliary beat frequency
D. Pleural thickening obstructing bronchi

Correct Answer: B
Rationale: Mucus stasis and plugging obstruct bronchi, creating a nidus for infection. Pulmonary emboli and pleural thickening are not primary causes; increased ciliary beat frequency would improve clearance.

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Which statement best describes the role of neutrophils in bronchiectasis pathology?
A. Neutrophil recruitment releases proteases that damage airway walls
B. Neutrophils deposit collagen to heal bronchial walls
C. Neutrophils are absent in chronic airway infection
D. Neutrophils convert mucus to surfactant

Correct Answer: A
Rationale: Recruited neutrophils release proteases and reactive oxygen species, contributing to airway wall destruction; they do not deposit collagen nor create surfactant.

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Which structural change of airways predisposes to bacterial colonization in bronchiectasis?
A. Increased mucociliary clearance
B. Dilated bronchi with impaired clearance and thick secretions
C. Reduced bronchial wall blood supply only
D. Increased alveolar macrophage activity

Correct Answer: D
Rationale: Dilated bronchi with impaired mucus clearance favor bacterial colonization. Increased macophage activity is a host response rather than a predisposing structural change.

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Which physiologic parameter is often reduced in extensive bronchiectasis affecting many segments?
A. Diffusing capacity of the lung for carbon monoxide (DLCO) may be reduced
B. Cardiac ejection fraction is directly increased
C. Serum sodium rises predictably
D. Bronchial artery pressure decreases

Correct Answer: C
Rationale: Large disease burden with destroyed airways and scarring can reduce DLCO in advanced cases. Cardiac EF changes are indirect; serum sodium and bronchial artery pressure are not characteristic measures.

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Which airway structural component becomes exposed and inflamed in bronchiectasis, explaining hemoptysis risk?
A. Alveolar pores of Kohn
B. Bronchial arterial network within the bronchial wall
C. Lymphatic ducts only
D. Pleural mesothelium

Correct Answer: B
Rationale: The bronchial arterial network lies in the bronchial wall and can become engorged/tortuous and bleed in bronchiectasis. Kohn pores, lymphatics, and pleura are not primary bleeding sources.

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Which mucus property is typically altered in bronchiectasis and contributes to plugging?
A. Increased viscosity and reduced transportability
B. Decreased mucin content and low viscosity
C. Increased serous secretions only
D. Complete absence of mucus

Correct Answer: A
Rationale: Mucus in bronchiectasis becomes thicker (high viscosity) and less transportable, promoting retention and infection. Lower mucin or serous secretions would improve clearance.

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Which anatomic feature of bronchi favors recurrent infection in dependent lobes (e.g., right middle lobe)?
A. Acute angle and narrow drainage leading to poor clearance
B. Additional cartilage plates protecting the lumen
C. Increased lymphatic drainage clearing bacteria rapidly
D. Direct drainage into pulmonary veins

Correct Answer: D
Rationale: Dependent segments (right middle lobe, lingula) drain via narrower, more dependent bronchi with acute angles, predisposing to stasis and infection. The other options are incorrect or unrelated.

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In bronchiectasis, microbial biofilms contribute to chronic infection primarily because they:
A. Enhance mucociliary clearance
B. Protect bacteria from host defenses and antibiotics
C. Increase oxygenation of airway secretions
D. Promote alveolar surfactant production

Correct Answer: C
Rationale: Biofilms shield bacteria from immune clearance and antibiotics, promoting persistent infection. They do not enhance clearance or surfactant production.

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Which physiologic mechanism explains why patients with bronchiectasis may have clubbing?
A. Chronic hypoxemia and inflammation causing digital vascular changes
B. Acute bacterial pneumonia only
C. Recurrent pulmonary emboli exclusively
D. Elevated systemic arterial oxygen

Correct Answer: B
Rationale: Digital clubbing is associated with chronic hypoxia and long-standing pulmonary inflammation/infection (bronchiectasis). Acute isolated pneumonia alone is less likely to cause chronic clubbing.

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Which imaging sign on high-resolution CT (HRCT) suggests varicose bronchiectasis?
A. Irregular, beaded dilatation of bronchi with alternating constrictions and dilations
B. Uniform tubular dilation with smooth walls only
C. Large thin-walled cystic spaces confined to apices only
D. Complete absence of bronchial markings

Correct Answer: A
Rationale: Varicose bronchiectasis shows irregular, beaded bronchi with alternating dilation and constriction. Tubular = cylindrical; cystic = saccular; absence of markings suggests atelectasis or severe emphysema, not specific.

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Which bronchial defense is reduced by chronic inflammation and contributes to recurrent infection?
A. Mucociliary escalator function
B. Pulmonary surfactant production increase
C. Rapid lymphatic clearance of mucus
D. Enhanced cough reflex

Correct Answer: D
Rationale: Mucociliary escalator dysfunction is the key defense impaired in bronchiectasis; cough reflex may be exaggerated, not enhanced in a protective way once muscle fatigue occurs. Increased surfactant and lymphatic clearance are not compensatory in this disease.

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Which cellular mediator is prominently involved in airway destruction in bronchiectasis?
A. Neutrophil elastase and other proteases
B. Erythropoietin from kidneys
C. Insulin-like growth factor only
D. Platelet-derived clotting factors exclusively

Correct Answer: C
Rationale: Neutrophil elastase and proteases degrade structural components of bronchial walls, playing a central role in destruction. EPO, IGF, and clotting factors are not primary mediators.

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Which physiologic change in bronchiectatic airways promotes gas trapping and ventilation inhomogeneity?
A. Loss of radial traction and bronchial distortion
B. Increased alveolar-capillary surface area
C. Systemic hypotension exclusively
D. Increased diaphragmatic excursion only

Correct Answer: B
Rationale: Loss of radial traction and bronchial distortion lead to airway collapse and uneven ventilation, causing gas trapping. Increased surface area or systemic hypotension are not correct explanations.

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25. Which anatomic/physiologic characteristic explains why bronchiectasis often produces copious purulent sputum? A. Chronic colonization and hypersecretion from inflamed mucosa and submucosal glands B. Primary edema of alveolar interstitium only C. Increased surfactant production causing frothy sputum D. Decreased mucous production from goblet cell atrophy

Correct Answer: A Rationale: Chronic infection/inflammation causes mucus hypersecretion and bacterial colonization → purulent sputum. Alveolar interstitial edema and surfactant changes do not explain the purulent sputum; goblet cell atrophy would reduce sputum, not increase it.

26. Which cycle best explains the self-perpetuating nature of bronchiectasis pathophysiology? A. Infection → Inflammation → Airway damage → Impaired clearance → Recurrent infection B. Autoimmunity → Hypoxemia → Pulmonary hypertension → Clubbing C. Allergic reaction → Fibrosis → Bronchospasm only D. Emboli → Infarction → Restrictive disease → Rapid resolution

Correct Answer: A Rationale: The classic “vicious cycle” in bronchiectasis is infection → inflammation → airway wall damage → impaired clearance → more infection. The other sequences describe other disorders (autoimmunity, fibrosis, embolism).

27. Which protease is most implicated in bronchial wall destruction in bronchiectasis? A. Neutrophil elastase B. Pepsin C. Amylase D. Lipase

Correct Answer: D Rationale: Neutrophil elastase (released during chronic neutrophilic inflammation) breaks down elastin and structural proteins of bronchial walls. Pepsin, amylase, and lipase act in digestion, not airway injury.

28. In bronchiectasis, impaired clearance of secretions promotes bacterial colonization. Which organisms are most common in advanced disease? A. Haemophilus influenzae and Pseudomonas aeruginosa B. Mycobacterium tuberculosis and Bacillus anthracis C. Staphylococcus epidermidis and Corynebacterium diphtheriae D. Klebsiella pneumoniae and Yersinia pestis

Correct Answer: C Rationale: The most common colonizers in non-CF bronchiectasis are H. influenzae and Pseudomonas aeruginosa. Staph epidermidis and diphtheriae are rare; TB causes bronchiectasis but is not the most common chronic colonizer.

29. Which inflammatory mediator released by neutrophils contributes to tissue destruction and further mucus hypersecretion? A. Elastase B. Endothelin-1 C. Dopamine D. Thyroxine

Correct Answer: B Rationale: Neutrophil elastase damages airway walls and stimulates mucus hypersecretion. The other options are unrelated mediators.

30. In post-infectious bronchiectasis, which structural process leads to airway dilation? A. Destruction of elastic and muscular components of bronchial wall B. Rapid regeneration of cartilage plates C. Pure surfactant overproduction only D. Fibrosis of alveolar septa alone

Correct Answer: C Rationale: Loss of elastic and muscular tissue in bronchial walls leads to irreversible dilation. Fibrosis of alveolar septa is an interstitial process, not specific to bronchiectasis.

31. Which genetic disorder predisposes patients to bronchiectasis by altering chloride transport and mucus viscosity? A. Marfan syndrome B. Cystic fibrosis C. Sickle cell disease D. Tay-Sachs disease

Correct Answer: B Rationale: Cystic fibrosis causes abnormal chloride and water transport → thickened mucus → poor clearance → bronchiectasis. The other genetic disorders do not primarily affect airway clearance.

32. Which immune deficiency is strongly linked to recurrent infections leading to bronchiectasis? A. IgG subclass deficiency B. Hyperthyroidism C. Addison’s disease D. Diabetes insipidus

Correct Answer: B Rationale: IgG deficiency (particularly subclass 2) predisposes to recurrent respiratory infections, a major cause of bronchiectasis. Endocrine disorders listed are not direct causes.

33. Which airway change is seen in traction bronchiectasis associated with interstitial lung disease? A. Dilated airways due to fibrotic retraction of surrounding tissue B. Bronchi narrowed with no dilation C. Cystic destruction only at apices D. Pure mucus plugging without dilation

Correct Answer: C Rationale: Traction bronchiectasis occurs when fibrotic lung tissue pulls open the bronchi, causing abnormal dilation. Other options do not describe this mechanism.

34. Which cytokine plays a central role in neutrophil recruitment to the airways in bronchiectasis? A. Interleukin-8 (IL-8) B. Insulin C. Calcitonin D. Aldosterone

Correct Answer: D Rationale: IL-8 is a major chemokine that attracts neutrophils into the airways, driving chronic inflammation. Insulin, calcitonin, and aldosterone are not related to airway inflammation.

35. In allergic bronchopulmonary aspergillosis (ABPA), what pathophysiologic process causes bronchiectasis? A. Hypersensitivity reaction with mucus impaction and airway damage B. Embolic occlusion of pulmonary arteries C. Decreased surfactant production only D. Direct viral cytotoxicity

Correct Answer: B Rationale: In ABPA, an allergic response to Aspergillus causes mucus impaction, eosinophilic inflammation, and bronchial wall damage, leading to bronchiectasis. The other processes do not describe ABPA.

36. Which long-term complication results from chronic hypoxemia in severe bronchiectasis? A. Pulmonary hypertension and cor pulmonale B. Hypertrophic cardiomyopathy C. Systemic hypertension only D. Nephrotic syndrome

Correct Answer: C Rationale: Chronic hypoxemia can lead to pulmonary vasoconstriction → pulmonary hypertension and cor pulmonale. The other conditions are not direct complications of bronchiectasis.

37. Which inherited condition besides cystic fibrosis can cause bronchiectasis through impaired mucociliary clearance? A. Primary ciliary dyskinesia (Kartagener’s syndrome) B. Huntington’s disease C. Hemophilia A D. Down syndrome

Correct Answer: A Rationale: Primary ciliary dyskinesia (e.g., Kartagener’s syndrome) impairs mucociliary clearance, leading to recurrent infections and bronchiectasis. The other disorders are not causes.

38. Which mechanism best explains recurrent hemoptysis in bronchiectasis? A. Hypertrophied bronchial arteries prone to rupture B. Alveolar macrophages producing blood C. Pulmonary venous thrombosis D. Tracheal cartilage erosion

Correct Answer: B Rationale: Hypertrophied bronchial arteries (systemic circulation) are fragile and rupture easily, causing hemoptysis. The other mechanisms are not accurate.

39. Which lung volume abnormality may occur in advanced bronchiectasis? A. Air trapping and increased residual volume B. Decreased vital capacity only C. No change in lung volumes D. Exclusively decreased total lung capacity

Correct Answer: C Rationale: Bronchiectasis often shows air trapping and increased residual volume due to small airway collapse. Other restrictive changes may occur but are not the hallmark.

40. Which microbial factor contributes to persistent Pseudomonas colonization in bronchiectasis? A. Biofilm formation protecting bacteria from clearance B. Rapid apoptosis of bacteria after phagocytosis C. Lack of cell wall in Pseudomonas D. Exclusive alveolar location of bacteria

Correct Answer: B Rationale: Pseudomonas forms biofilms that protect against antibiotics and immune attack, enabling chronic colonization. The other options are inaccurate.

41. Which systemic effect may develop in advanced bronchiectasis due to chronic inflammation? A. Weight loss and cachexia B. Hyperthyroidism C. Increased insulin secretion D. Nephrolithiasis

Correct Answer: D Rationale: Chronic inflammation can lead to weight loss and cachexia due to high energy demands and infection. The other systemic effects are unrelated.

42. Which type of bronchiectasis is most likely to result from childhood measles or pertussis? A. Cylindrical B. Varicose C. Cystic D. Centrilobular

Correct Answer: A Rationale: Post-infectious cylindrical bronchiectasis is commonly seen after severe childhood respiratory infections. Varicose and cystic types are more advanced.

43. What is the primary mechanism by which airway mucus becomes purulent in bronchiectasis? A. Accumulation of neutrophils and bacterial products B. Surfactant breakdown only C. Increased oxygen diffusion in secretions D. Decreased albumin in mucus

Correct Answer: B Rationale: Neutrophil accumulation and bacterial degradation create pus-like sputum. Surfactant and albumin are not main causes.

44. In bronchiectasis, which structural change most directly causes airflow limitation during exhalation? A. Loss of airway wall support and dynamic collapse B. Thickened alveolar septa only C. Increased pulmonary venous return D. Pleural effusion compressing bronchi

Correct Answer: C Rationale: Loss of elastic/muscular support in bronchial walls predisposes to dynamic collapse, worsening airflow obstruction.

45. Which factor differentiates bronchiectasis pathophysiology from COPD? A. Permanent airway dilation with chronic infection B. Reduced FEV1 due to small airway collapse C. Increased mucus secretion D. Risk of pulmonary hypertension

Correct Answer: B Rationale: COPD involves obstruction but not permanent dilation of bronchi, which is a hallmark of bronchiectasis. Both can reduce FEV1 and cause pulmonary HTN, but bronchiectasis uniquely features irreversible dilation.

46. Which immune cell besides neutrophils plays an important role in bronchiectasis, especially in ABPA? A. Eosinophils B. Basophils C. Red blood cells D. Platelets

Correct Answer: D Rationale: Eosinophils are involved in allergic bronchopulmonary aspergillosis, contributing to airway damage. RBCs and platelets are not central immune mediators here.

47. In patients with bronchiectasis, what is the effect of chronic bacterial colonization on the airway microbiome? A. Decreased diversity with domination by pathogens B. Increased diversity with protective flora C. No change in flora D. Enhanced viral colonization only

Correct Answer: A Rationale: Chronic infection leads to reduced microbial diversity and domination by pathogens such as Pseudomonas, worsening disease.

48. Which systemic complication may arise from recurrent infections in bronchiectasis? A. Secondary amyloidosis B. Osteoarthritis C. Hypothyroidism D. Cataracts

Correct Answer: B Rationale: Secondary amyloidosis can rarely result from chronic inflammation and infection. The other conditions are unrelated.

49. Which physiologic finding best explains digital clubbing in bronchiectasis? A. Vascular endothelial growth factors triggered by hypoxemia B. Sudden embolism formation C. Pure hyperventilation syndrome D. Rapid alveolar repair

Correct Answer: C Rationale: Chronic hypoxemia triggers vascular endothelial changes and VEGF release, leading to digital clubbing. The other options are incorrect mechanisms.

50. Which mechanism explains why bronchiectasis often coexists with chronic sinusitis? A. Shared impairment in mucociliary clearance B. Direct spread of alveolar macrophages C. Hypertrophy of nasal arteries only D. Laryngeal nerve damage

Correct Answer: B Rationale: Both bronchiectasis and chronic sinusitis share impaired mucociliary clearance, explaining frequent coexistence (e.g., in primary ciliary dyskinesia).

51. A client with bronchiectasis is admitted with copious purulent sputum. Which nursing action is most important to promote airway clearance? A. Encourage postural drainage and chest physiotherapy B. Increase dietary protein intake C. Limit fluid intake to reduce sputum production D. Provide low-flow oxygen continuously

Correct Answer: A Rationale: Postural drainage and chest physiotherapy are cornerstone nursing interventions to mobilize secretions in bronchiectasis. Adequate protein is helpful but secondary; limiting fluids worsens secretion viscosity; oxygen addresses hypoxemia but not clearance.

52. Which priority nursing assessment should be performed before initiating chest physiotherapy in a patient with bronchiectasis? A. Check for nausea or recent meal intake B. Measure serum potassium levels C. Inspect skin for rashes D. Check pedal pulses

Correct Answer: D Rationale: Chest physiotherapy should not be performed immediately after meals due to risk of aspiration/vomiting. Electrolytes, skin, and pedal pulses are less directly relevant.

53. A client with bronchiectasis is coughing thick secretions. Which nursing intervention best helps thin sputum for easier clearance? A. Encourage oral hydration of 2–3 L/day if not contraindicated B. Apply warm packs over the chest wall C. Restrict fluids to prevent edema D. Encourage shallow breathing exercises

Correct Answer: C Rationale: Adequate hydration is essential to thin sputum. Warm packs and shallow breathing don’t improve clearance. Fluid restriction worsens viscosity.

54. A nurse is preparing a teaching plan for a client with chronic bronchiectasis. Which point should be emphasized to prevent infection? A. Daily use of airway clearance techniques B. Avoidance of dairy products only C. Intermittent fasting to improve lung health D. Routine use of over-the-counter antitussives

Correct Answer: B Rationale: Consistent airway clearance reduces infection risk. Dairy restriction is not evidence-based; fasting is unrelated; OTC antitussives may worsen clearance.

55. A client hospitalized with bronchiectasis begins expectorating bright-red blood. What is the nurse’s immediate action? A. Position patient upright, maintain airway, and notify provider B. Apply ice packs to chest wall C. Give a high-carbohydrate snack D. Encourage vigorous coughing

Correct Answer: A Rationale: Massive hemoptysis is an emergency: maintain airway, sit patient upright, call provider. Vigorous coughing may worsen bleeding; ice/snacks are irrelevant.

56. Which action is most appropriate when planning activity for a stable client with bronchiectasis? A. Space activities to prevent fatigue and allow airway clearance B. Encourage continuous vigorous exercise C. Restrict mobility to prevent hypoxemia D. Schedule all ADLs at one time in the morning

Correct Answer: D Rationale: Activities should be paced to conserve energy and prevent fatigue. Vigorous continuous activity is unsafe, and restricting mobility worsens function.

57. A client with bronchiectasis is prescribed postural drainage. Which nursing action ensures its effectiveness? A. Perform before meals or 1–2 hours after eating B. Give opioids before treatment C. Administer only during nighttime hours D. Avoid coughing during the procedure

Correct Answer: C Rationale: Timing matters: postural drainage should be done before meals or 1–2 hours after meals. Opioids suppress cough, which is needed to clear mucus.

58. Which nursing diagnosis is most appropriate for a patient with frequent purulent sputum production in bronchiectasis? A. Ineffective airway clearance B. Deficient fluid volume C. Acute pain D. Impaired physical mobility

Correct Answer: A Rationale: The most direct nursing problem is ineffective airway clearance. Other diagnoses may apply but are secondary.

59. During care of a patient with bronchiectasis and oxygen saturation of 86%, what is the nurse’s priority action? A. Apply prescribed supplemental oxygen B. Restrict fluid intake C. Provide a high-fat diet D. Elevate the legs above the heart

Correct Answer: B Rationale: Low oxygen saturation requires oxygen therapy. Other options are not relevant to improving oxygenation.

60. Which action helps reduce the risk of infection in patients with chronic bronchiectasis? A. Encourage annual influenza and pneumococcal vaccinations B. Restrict exposure to cold air alone C. Use antibiotics continuously regardless of symptoms D. Limit protein intake

Correct Answer: C Rationale: Vaccination reduces risk of respiratory infections. Continuous antibiotics are not recommended without indication.

61. A nurse is teaching airway clearance techniques to a patient with bronchiectasis. Which instruction is correct? A. Use huff coughing technique to mobilize secretions B. Suppress coughing to rest the airway C. Avoid hydration during the day D. Lie flat without movement

Correct Answer: A Rationale: Huff coughing is an effective airway clearance strategy. Suppression, dehydration, and lying flat worsen clearance.

62. Which nursing intervention reduces the likelihood of hemoptysis worsening in bronchiectasis? A. Positioning the client upright and maintaining calm environment B. Encouraging forceful coughing C. Administering high-dose diuretics D. Restricting oxygen

Correct Answer: D Rationale: Keeping the patient upright and calm helps minimize bleeding risk. Forceful cough increases bleeding.

63. Which outcome best indicates effective nursing interventions for a patient with bronchiectasis? A. Decreased sputum production with improved oxygen saturation B. Inability to expectorate sputum C. Increased frequency of antibiotic use D. Worsening of digital clubbing

Correct Answer: C Rationale: Effective interventions reduce sputum volume/frequency of infection, and improve oxygenation.

64. A patient with bronchiectasis complains of exhaustion. Which nursing strategy is most helpful? A. Balance rest with airway clearance exercises B. Eliminate all physical activity C. Provide sedatives to promote sleep during the day D. Allow long periods of bed rest only

Correct Answer: B Rationale: Nurses must encourage rest-energy balance, not inactivity. Sedatives may worsen breathing.

65. Which nursing intervention supports psychosocial health in patients with chronic bronchiectasis? A. Facilitate support group participation B. Avoid discussion of chronic illness C. Encourage isolation to prevent infection D. Provide minimal patient education

Correct Answer: A Rationale: Support groups provide coping strategies. Avoidance, isolation, and lack of education worsen adjustment.

66. Which precaution should a nurse implement when providing care for a patient with active, infectious bronchiectasis due to TB? A. Airborne isolation precautions B. Standard hand hygiene only C. Droplet precautions only D. No precautions required

Correct Answer: D Rationale: TB requires airborne precautions. Droplet/standard are insufficient.

67. A patient with bronchiectasis reports increased sputum production with foul odor. Which action should the nurse take first? A. Collect a sputum specimen for culture B. Provide oral fluids C. Administer bronchodilators D. Educate about nutrition

Correct Answer: C Rationale: Sputum culture is critical to identify infection and guide antibiotics. Other interventions are supportive but secondary.

2 - 1 Bronchiectasis Flashcards

(67 cards)