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In which way does pursed lip breathing assist patients with asthma during an attack?
- A. It distracts the patient with breathing technique to reduce anxiety.
- B. It gets rid of CO2 faster.
- C. It decreases breathing efforts.
- D. It increases PACO2.
Correct Answer: C
Rationale: Pursed lip breathing decreases the effort of breathing.
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In which manner would the nurse examining a patient with pleurisy document a low-pitched grating lung sound?
- A. Sonorous wheeze
- B. Friction rub
- C. Coarse crackles
- D. Crackles
Correct Answer: B
Rationale: A low-pitched grating sound in the presence of an inflammatory disorder is a friction rub.
The patient with long-term emphysema is admitted with a secondary diagnosis of cor pulmonale. Which symptoms will the patient likely exhibit?
- A. Edema of the lower extremities and extended neck veins due to hypertension of the pulmonary circulation.
- B. A dry hacking cough and chest pain due to constriction of the pulmonary vein.
- C. Hypertension and a headache related to pulmonary hypertension.
- D. Unlabored respiration and cyanosis around the mouth.
Correct Answer: A
Rationale: COPD can lead to cor pulmonale, an abnormal cardiac condition characterized by hypertrophy of the right ventricle of the heart as a result of hypertension of the pulmonary circulation. Cor pulmonale results in the presence of edema in the lower extremities, as well as in the sacral and perineal area, distended neck veins, and enlargement of the liver with ascites.
The patient has advanced emphysema and reports experiencing dyspnea and fatigue. Which nursing intervention would be appropriate for the patient who is having difficulty with activity tolerance?
- A. Direct patient in vigorous independent ROM.
- B. Allow to exercise until respirations are over 20 breaths/min over baseline.
- C. Plan care to provide optimum rest.
- D. Provide frequent cool showers.
Correct Answer: C
Rationale: Nursing interventions will be directed at attempting to decrease the patient's anxiety and promote optimal air exchange. The nurse should allow sufficient rest periods and should assist the patient in activities of daily living.
Which patient assessment indicates the most severe respiratory distress?
- A. Nasal flaring, symmetrical chest wall expansion, SaO2 88%
- B. Abdominal breathing, SaO2 97%
- C. Substernal retraction, SaO2 84%
- D. Substernal retraction, SaO2 90%
Correct Answer: C
Rationale: Observe the patient's facial expressions and signs of respiratory distress, such as flaring nostrils, substernal or clavicular retractions, asymmetrical chest wall expansion, and abdominal breathing. The lower the SaO2, the more severe the respiratory distress.
Which important precaution should the nurse include when instructing a patient with emphysema on the use of home oxygen?
- A. Use oxygen only when extremely short of breath.
- B. Keep the home oxygen regulator set on 6 L.
- C. Use home oxygen at night while sleeping.
- D. Limit to 1 to 2 L oxygen flow.
Correct Answer: D
Rationale: Low-flow oxygen therapy is required for patients with COPD, because higher oxygen concentrations depress the body's own respiratory regulatory centers and can cause respiratory failure.