While assessing a new patient on the unit, the nurse notes productive cough, respiratory rate of 22, oxygen saturation of 90%, and increased secretions. the patient has a 20-year history of smoking 1.5 packs of cigarettes daily. what chronic condition might this patient have?

Your most likely looking at some form of COPD, or Chronic Obstructive Pulmonary Disease. COPD is usually a common chronic illness that results smoking after a while due to mucus produced to keep smoke, a foreign substandard out of the aveoli, this then becomes a more serious problem when the body expands the aveoli to allow a greater surface are but instead increases the dead space. COPD is common in elderly who smoke.

COPD come in two forms, Emphysema which is a dry COPD, and Chronic Bronchitis which is wet and usually leaves a patient bedridden much of the time.

Judging by the description I'd say COPD or Chronic Bronchitis.

Iwould say being around others who are not drug free is the wrong step because your peers are likely to influence any new or past habits