Nokea
You are providing teaching to a patient with chronic COPD on how to perform diaphragmatic breathing. This technique helps do the following:
- A. Increase the breathing rate to prevent hypoxemia
- B. Decrease the use of the abdominal muscles
- C. Encourages the use of accessory muscles to help with breathing
- D. Strengthen the diaphragm
Correct Answer: D
Rationale: Diaphragmatic breathing strengthens the diaphragm , improving breathing efficiency in COPD. It doesn't increase breathing rate , decrease abdominal muscle use , or encourage accessory muscle use .
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Until the client can be examined later that morning, which advice by the nurse would be most helpful?
- A. Sucking on ice chips should help.
- B. Rest your voice.
- C. Massage your throat.
Correct Answer: B
Rationale: Resting the voice reduces strain on the vocal cords, which is beneficial for laryngitis and helps prevent further irritation.
The nurse is discharging the client diagnosed with bronchiolitis obliterans. Which priority intervention should the nurse include?
- A. Refer the client to the American Lung Association.
- B. Notify the physical therapy department to arrange for activity training.
- C. Arrange for oxygen therapy to be used at home.
- D. Discuss advance directives with the client.
Correct Answer: C
Rationale: Bronchiolitis obliterans causes irreversible airway obstruction, often requiring home oxygen therapy (C) to manage hypoxemia, a priority for discharge planning. Referrals (A), physical therapy (B), and advance directives (D) are important but secondary to ensuring oxygenation.
You're caring for a patient with pneumonia. The patient has just started treatment for pneumonia and is still experiencing hypoxemia. You know that respiratory acidosis is very common with patients with pneumonia. Which arterial blood gases below represent respiratory acidosis that is NOT compensated?
- A. pH 7.29, PaCO2 55, HCO3 23, PO2 85
- B. pH 7.48, PaCO2 35, HCO3 22, PO2 85
- C. pH 7.20, PaCO2 20, HCO3 28, PO2 85
- D. pH 7.55, PaCO 63, HCO3 19, PO2 85
Correct Answer: A
Rationale: Respiratory acidosis is characterized by low pH (<7.35) and high PaCO2 (>45). Option A (pH 7.29, PaCO2 55, HCO3 23) shows uncompensated respiratory acidosis, as HCO3 is normal, indicating no renal compensation. Other options show normal pH, respiratory alkalosis, or invalid data.
While developing the postoperative care plan for the client, it is essential to have the client lie in which position?
- A. With the healthy lung uppermost
- B. With the head lower than the heart
- C. With the arms elevated on pillows
- D. On the operative side
Correct Answer: A
Rationale: Positioning with the healthy lung uppermost optimizes ventilation and perfusion in the remaining lung post-pneumonectomy.
The nurse is caring for a client with a right-sided chest tube that is accidentally pulled out of the pleural space. Which action should the nurse implement first?
- A. Notify the health-care provider to have chest tubes reinserted STAT.
- B. Instruct the client to take slow shallow breaths until the tube is reinserted.
- C. Take no action and assess the client's respiratory status every 15 minutes.
- D. Tape a petroleum jelly occlusive dressing on three (3) sides to the insertion site.
Correct Answer: D
Rationale: An occlusive dressing taped on three sides (D) prevents air entry while allowing air exit, a priority. Notification (A), shallow breaths (B), and monitoring (C) follow.