A client with chronic obstructive pulmonary disease (COPD) is experiencing tachypnea and dyspnea. The nurse should plan to implement which of the following interventions to reduce bronchiolar collapse and air-trapping?

Instruct the client on pursed-lip breathing

Place the client in Trendelenburg position

Apply a high-frequency chest wall oscillation vest

Determine the client's FEV1/FVC ratio

Answer and Explanation

The Correct Answer is A

A.   Pursed-lip breathing is an effective technique for managing COPD symptoms, particularly tachypnea and dyspnea. It helps to keep the airways open by creating back pressure that prevents the collapse of bronchioles and reduces air-trapping. This technique improves ventilation and helps with the expiration of trapped air, making it a valuable intervention for COPD patients.
B.   The Trendelenburg position involves lying flat on the back with the legs elevated higher than the head. This position is not suitable for managing COPD symptoms and can actually worsen breathing difficulties by increasing abdominal pressure on the diaphragm.
C.   High-frequency chest wall oscillation (HFCWO) vests are used to help with airway clearance in conditions like cystic fibrosis or chronic bronchitis by loosening mucus. While beneficial for mucus management, they do not specifically address bronchiolar collapse or air-trapping associated with COPD.
D.   Measuring the FEV1/FVC ratio is a diagnostic tool used to assess the severity of airflow obstruction in COPD. While this information is important for diagnosis and treatment planning, it is not an immediate intervention to manage symptoms such as tachypnea and dyspnea.

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Correct Answer is D

Explanation

A. Cool, clammy skin can be a sign of a myocardial infarction. It occurs due to the body's stress response during an MI, leading to decreased perfusion and sweating. This symptom is consistent with the autonomic response to a heart attack.
B. Chest pain radiating into the back, jaw, or arms is a classic symptom of myocardial infarction. This radiation of pain is due to the way pain signals are transmitted and referred from the heart to other parts of the body. It is a common and significant symptom of MI.

C. Nausea and vomiting can occur during a myocardial infarction, particularly in older adults. These symptoms are related to the autonomic nervous system's response to the stress of an MI and can sometimes be the presenting symptoms, especially in women and older adults.
D. Peripheral edema is generally not a direct symptom of myocardial infarction. It is more commonly associated with chronic heart failure or other conditions leading to fluid overload. While MI can lead to heart failure over time, peripheral edema itself is not a typical acute symptom of an MI.

A. Women with lupus should ensure that they get plenty of sun each day while they are pregnant. B. Women with lupus should not become pregnant, because the disease poses too many risks. C. Women with lupus should have frequent prenatal visits and close monitoring of lupus symptoms during pregnancy. D. Women with lupus should avoid all medications during pregnancy to prevent harm to the baby.

Correct Answer is C

Explanation

A. Women with lupus should ensure that they get plenty of sun each day while they are pregnant. Exposure to sunlight can exacerbate lupus symptoms, especially in women with lupus photosensitivity. It's important for women with lupus to avoid excessive sun exposure and wear protective clothing and sunscreen.

B. Women with lupus should not become pregnant, because the disease poses too many risks. While pregnancy can pose additional risks for women with lupus, it is not always contraindicated. With proper management, many women with lupus can have healthy pregnancies.
C. It is important for women with lupus to receive frequent prenatal care and close monitoring of their lupus symptoms throughout pregnancy. This includes regular check-ups with a rheumatologist and obstetrician, monitoring of blood pressure, kidney function, and lupus activity, as well as screening for fetal development.
D. Women with lupus should avoid all medications during pregnancy to prevent harm to the baby. This is not always the case. Some medications may be necessary to manage lupus symptoms during pregnancy, and the benefits often outweigh the risks. It's important to discuss medication options with healthcare providers to determine the best course of action.

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A client with chronic obstructive pulmonary disease (COPD) is experiencing tachypnea and dyspnea. The nurse should plan to implement which of the following interventions to reduce bronchiolar collapse and air-trapping?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing education to a group of older adults about the signs and symptoms of a myocardial infarction. Which of the following is not a sign of a myocardial infarction?

Correct Answer is D

Explanation

A female client with systemic lupus erythematosus (SLE) asks the nurse about pregnancy and lupus. Which information should the nurse include when educating the client?

Correct Answer is C

Explanation

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