Nokea
After the nurse has finished teaching a patient about pursed lip breathing, which of the following patient actions indicate that more teaching is needed?
- A. The patient inhales slowly through the nose.
- B. The patient tenses the neck muscles while exhaling.
- C. The patient practises by blowing through a straw.
- D. The patient's ratio of inhalation to exhalation is 1:3.
Correct Answer: B
Rationale: The patient should relax the neck and shoulder muscles while doing pursed lip breathing. The other actions by the patient indicate a good understanding of pursed lip breathing.
You may also like to solve these questions
The nurse is developing a teaching plan to help increase activity tolerance at home for a 70-year-old patient with severe chronic obstructive pulmonary disease (COPD). Which of the following exercise goals should the nurse teach the patient?
- A. Walk until pulse rate exceeds 130.
- B. Walk for a total of 20 minutes daily.
- C. Exercise until shortness of breath occurs.
- D. Limit exercise to activities of daily living (ADLs).
Correct Answer: B
Rationale: The goal for exercise programs for patients with COPD is to increase exercise time gradually to a total of 20 minutes daily. Shortness of breath is normal with exercise and not an indication that the patient should stop. Limiting exercise to ADLs will not improve the patient's exercise tolerance. A 70-year-old patient should have a pulse rate of 120 or less with exercise (80% of the maximal heart rate of 150).
The following medications are prescribed by the health care provider for a patient having an acute asthma attack. Which medication should the nurse administer first?
- A. Salmeterol 50 mcg per dry-powder inhaler (DPI).
- B. Salbutamol 2.5 mg per nebulizer.
- C. Triamcinolone 2 puffs per metered-dose inhaler (MDI).
- D. Methylprednisolone 60 mg IV.
Correct Answer: B
Rationale: Salbutamol is a rapidly acting bronchodilator and is the first-line medication to reverse airway narrowing in acute asthma attacks. It is known as an asthma rescue medication. The other medications work more slowly.
The nurse is assessing a patient in the asthma clinic who has recorded daily peak flows that are 85% of the baseline. Which of the following actions should the nurse plan to take?
- A. Teach the patient about the use of oral corticosteroids.
- B. Administer a bronchodilator and recheck the peak flow.
- C. Instruct the patient to continue to use current medications.
- D. Evaluate whether the peak flow meter is being used correctly.
Correct Answer: C
Rationale: The patient's peak flow readings indicate good asthma control (values over 80%) and no changes are needed. The other actions would be used for patients in the yellow or red zones for peak flow.
The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) who has rhonchi throughout the lung fields and a chronic, nonproductive cough. Which of the following nursing actions is best?
- A. Change the oxygen flow rate to the highest prescribed rate.
- B. Reinforce the ongoing use of pursed lip breathing techniques.
- C. Educate the patient to use the Flutter airway clearance device.
- D. Teach the patient about consistent use of inhaled corticosteroids.
Correct Answer: C
Rationale: Airway clearance devices assist with moving mucus into larger airways where it can more easily be expectorated. The other actions may be appropriate for some patients with COPD, but they are not as effective for addressing rhonchi and nonproductive cough.
The nurse is admitting a patient with chronic obstructive pulmonary disease (COPD) to the hospital. Which of the following positions should the nurse place the patient in to improve gas exchange?
- A. Resting in bed with the head elevated to 45-60 degrees.
- B. Sitting up at the bedside in a chair and leaning slightly forward.
- C. Resting in bed in a high Fowler's position with the knees flexed.
- D. In the Trendelenburg position with several pillows behind the head.
Correct Answer: B
Rationale: Patients with COPD improve the mechanics of breathing by sitting up in the 'tripod' position. Resting in bed with the head elevated would be an alternative position if the patient was confined to bed, but sitting in a chair allows better ventilation. The Trendelenburg position or sitting upright in bed with the knees flexed would decrease the patient's ability to ventilate well.