A client diagnosed with emphysema states that it is uncomfortable to sit in a semi-Fowler's position. In order to best decrease the work of breathing, the nurse should assist the client to:
Move into a side-lying position with the head elevated.
Lay in the Trendelenburg position.
Lean over the bedside table.
Sit in Fowler's position with heels off the bed.
The Correct Answer is C
Choice A Reason:
A side-lying position with the head elevated may provide some comfort but is not the most effective position for reducing the work of breathing in emphysema patients. This position does not maximize lung expansion or aid in the optimal use of respiratory muscles.
Choice B Reason:
The Trendelenburg position, where the body is laid flat on the back with the feet higher than the head, is not recommended for emphysema patients as it can increase the pressure on the diaphragm, making breathing more difficult.
Choice C Reason:
Leaning over the bedside table, often referred to as the tripod position, is beneficial for emphysema patients. This position allows for the optimal use of respiratory muscles and helps to reduce the work of breathing by supporting the arms and allowing the shoulder girdle muscles to assist in the breathing process.
Choice D Reason:
Fowler's position, where the patient is seated with the legs either bent or straight out in front, may not be as effective as the tripod position for emphysema patients. While it does allow for better lung expansion than lying flat, it does not provide the same level of support for the respiratory muscles as leaning forward does.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
A positive pregnancy test is crucial information that must be reported immediately as it has significant implications for the patient's health and treatment options. Pregnancy can impact the results of a Schilling's test, which is used to diagnose B12 deficiency anemia, as pregnancy itself can cause changes in B12 metabolism. Therefore, the healthcare provider must be informed to adjust the diagnostic approach and ensure the safety of both the mother and the developing fetus.
Choice B Reason:
While a hemoglobin level of 9.5 g/dL is below the normal range for adult females (11.6 to 15 g/dL) and a hematocrit of 32% is at the lower end of the normal range (36% to 44%)[^10^], these results are consistent with anemia but are not as immediately critical as a positive pregnancy test in the context of a Schilling's test.
Choice C Reason:
A glycosylated hemoglobin (A1c) level of 7.5% is above the normal range (4% to 5.9%), indicating poor blood sugar control over the past two to three months, which could suggest diabetes or prediabetes. However, this is not as urgent as a positive pregnancy test when considering the administration of a Schilling's test.
Choice D Reason:
A serum cholesterol level of 237 mg/dL is considered borderline high (200 to 239 mg/dL), which may increase the risk of heart disease over time. However, this does not require immediate reporting in the context of a Schilling's test for B12 deficiency anemia as compared to a positive pregnancy test.
Correct Answer is A
Explanation
Choice A Reason
A negative sputum culture is the most definitive indicator of the effectiveness of tuberculosis (TB) treatment. When a patient with active TB starts on medication, the goal is to eliminate the Mycobacterium tuberculosis bacteria from the body. A sputum culture that turns from positive to negative signifies that the bacteria have been eradicated from the respiratory secretions, indicating successful treatment.
Choice B Reason
While decreased hemoptysis (coughing up blood) is a positive sign and indicates an improvement in the patient's condition, it is not the most reliable parameter for determining the effectiveness of TB therapy. Hemoptysis may decrease as the patient's overall condition improves, but it does not confirm the eradication of the TB bacteria.
Choice C Reason
An improved chest x-ray can show a reduction in the lesions caused by TB, which is a good sign of recovery. However, chest x-rays cannot confirm whether the TB bacteria have been completely eliminated. They are more of a supportive indicator rather than a definitive one.
Choice D Reason
A decreased rate of coughing is another sign that the patient is responding to treatment, as coughing is a primary symptom of TB. However, similar to hemoptysis and chest x-ray improvements, a decrease in coughing does not necessarily mean that the TB bacteria have been fully cleared from the body.
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