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A nurse cares for a client who tests positive for alpha1-antitrypsin (AAT) deficiency. The client asks, 'What does this mean?' How should the nurse respond?
- A. Your children will be at high risk for the development of chronic obstructive pulmonary disease.
- B. I will contact a genetic counselor to discuss your condition.
- C. Your risk for chronic obstructive pulmonary disease is higher, especially if you smoke.
- D. This is a recessive gene and should have no impact on your health.
Correct Answer: C
Rationale: AAT deficiency increases the risk of COPD, particularly in smokers. Clients with one allele produce enough AAT to prevent COPD unless exposed to irritants like smoke. The risk to children depends on the partner's AAT status, and contacting a genetic counselor is not the priority response.
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A nurse is teaching a client who has cystic fibrosis (CF). Which statement should the nurse include in this client's teaching?
- A. Take an antibiotic each day.
- B. Contact your provider to obtain genetic screening.
- C. Eat a well-balanced, nutritious diet.
- D. Perform daily respiratory therapy exercises.
Correct Answer: C
Rationale: Clients with CF often experience malnourishment due to vitamin deficiency and pancreatic malfunction. A well-balanced, nutritious diet is essential for maintaining health. Daily antibiotics are not typically required, genetic screening is not relevant for management, and while respiratory therapy is important, it is not listed as an option.
The nurse instructs a client on the steps needed to obtain a peak expiratory flow rate. In which order should these steps occur? 1. Take as deep a breath as possible. 2. Stand up (unless you have a physical disability). 3. Place the meter in your mouth, and close your lips around the mouthpiece. 4. Make sure the device reads zero or is at base level. 5. Blow out as hard and as fast as possible for 1 to 2 seconds. 6. Write down the value obtained. 7. Repeat the process two additional times, and record the highest number in your chart.
- A. 4,2,1,3,5,6,7
- B. 1,2,3,4,5,6,7
- C. 2,1,3,4,5,6,7
- D. 1,3,2,5,6,7,4
Correct Answer: A
Rationale: The correct order is: ensure the device is at zero (4), stand up (2), take a deep breath (1), place the meter in the mouth (3), blow out hard and fast (5), record the value (6), and repeat twice, recording the highest value (7).
A nurse cares for a client with arthritis who reports frequent asthma attacks. Which action should the nurse take first?
- A. Review the client's pulmonary function test results.
- B. Review medications the client is currently taking.
- C. Assess how frequently the client uses a bronchodilator.
- D. Consider the report of the client with asthma phases.
Correct Answer: B
Rationale: Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can trigger asthma in some people due to increased production of leukotrienes when aspirin or NSAIDs suppress other inflammatory pathways. This is a high-priority action given the client's history. Reviewing pulmonary function test results will not address the immediate problem of frequent asthma attacks. Assessing bronchodilator use addresses interventions for attacks but not their cause. Considering asthma phases is not a priority action.
A nurse auscultates a client's lung fields. Which action should the nurse take based on the lung sounds? (Click the media button to hear the audio clip)
- A. Assess for airway obstruction.
- B. Initiate oxygen therapy.
- C. Assess vital signs.
- D. Elevate the client's head.
Correct Answer: A
Rationale: Stridor indicates severe airway constriction, requiring immediate assessment for airway obstruction. Administering oxygen, assessing vital signs, or elevating the head are secondary until the airway is addressed.
After teaching a client how to perform diaphragmatic breathing, the nurse assesses the client's understanding. Which action demonstrates that the client correctly understands the teaching?
- A. The client lays on his or her side with knees bent.
- B. The client places his or her hands on his or her abdomen.
- C. The client lays in a prone position with his or her legs straight.
- D. The client places his or her hands above his or her head.
Correct Answer: B
Rationale: To perform diaphragmatic breathing correctly, the client should place their hands on their abdomen to feel the rise and fall of the diaphragm. This type of breathing cannot be performed effectively while lying on the side, in a prone position, or with hands above the head.