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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A Reason
A client with paranoid personality disorder is typically not described as superficially charming. This description is more often associated with other personality disorders, such as antisocial personality disorder, where individuals may use charm to manipulate others for personal gain.

Choice B Reason
Being friendly and open is generally not characteristic of paranoid personality disorder. Individuals with this disorder are often wary of others and may be perceived as cold or distant due to their mistrust.

Choice C Reason
While intensity and impulsivity can be seen in various personality disorders, they are not the defining features of paranoid personality disorder. These traits are more commonly associated with borderline personality disorder.

Choice D Reason
Guarded and suspicious are hallmark descriptors for someone with paranoid personality disorder. Individuals with this condition are often very distrustful of others, suspecting that others have ulterior motives or are out to harm them. They may be preoccupied with doubts about the loyalty or trustworthiness of friends or associates.

A. Administer oxygen using a non-rebreather mask. B. Increase the rate of maintenance IV infusion. C. Elevate the client's legs. D. Place the client in the lateral position.

Correct Answer is D

Explanation

Choice A reason:
Administering oxygen using a non-rebreather mask is a subsequent step if initial measures do not improve fetal heart rate decelerations. It can help increase the amount of oxygen available to the fetus. Oxygen administration is a supportive measure that can be used if there are signs of fetal distress. In the scenario described, where the fetal heart rate slows after the start of a contraction with the lowest rate occurring after the peak, it suggests late decelerations, which are often associated with uteroplacental insufficiency. Administering oxygen can help increase the fetal oxygen reserve and is a common intervention during labor when there are concerns about fetal well-being.

Choice B reason:
Increasing the rate of maintenance IV infusion is typically considered when there is a concern for maternal hypotension or dehydration, which may not be the immediate cause of the observed fetal heart rate pattern. Increasing the rate of an IV infusion can help improve maternal hydration and blood pressure, which in turn can enhance placental perfusion. However, this intervention is more indirect and may not provide the immediate response needed to address fetal heart rate decelerations. It is typically considered after more direct interventions, such as repositioning the mother, have been attempted.

Choice C reason:
Elevating the client's legs can help improve venous return to the heart, potentially increasing maternal cardiac output and blood flow to the placenta. While this can be beneficial, it is not the primary intervention for late decelerations. Repositioning the mother to improve uteroplacental circulation is generally the first step.
Choice D reason:
Placing the client in the lateral position is often the first action taken when late decelerations are observed. This position helps improve uteroplacental blood flow and can quickly address potential issues related to fetal oxygenation. This position helps to relieve pressure on the inferior vena cava and aorta, which can be compressed by the gravid uterus, especially in the supine position. Relieving this pressure helps to improve uteroplacental circulation and can quickly address the cause of late decelerations, which is often related to compromised blood flow to the placenta.

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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:

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Naxlex Comprehensive Predictor Exams

The edited text with the question and the choices labeled from a to d is as follows: The nurse who assesses a client as having paranoid personality disorder is most likely to describe the client as:

Correct Answer is D

Explanation

Correct Answer is D

Explanation

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