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 A

Explanation

A. Age-related hearing loss, also known as presbycusis, is a common condition among older adults. It typically involves a gradual decline in hearing ability due to changes in the inner ear or auditory nerve as people age. This statement acknowledges a common experience and helps normalize the patient's condition without suggesting immediate medical intervention or attributing it to something specific.
B. While hearing aids can significantly improve the quality of life for individuals with hearing loss, not all cases immediately require them. It’s important to assess the severity of hearing loss and discuss various options with the patient, including potential benefits and drawbacks of hearing aids.
C. Hearing loss that develops gradually over time is usually related to aging, not an infection. While infections can cause temporary hearing loss, age-related hearing loss is a different issue and is typically not due to an infection.
D. While some medications can cause temporary or permanent hearing loss as a side effect (a condition known as ototoxicity), it’s important to consult a healthcare provider before making any changes to medication regimens.

A. Black, tarry stool B. Clay-colored stool C. Watery stool D. Bright red blood in the stool

Correct Answer is A

Explanation

A. Black, tarry stool is indicative of blood that has been digested in the upper GI tract. The dark color is due to the action of digestive enzymes on blood.
B. Clay-colored stool is typically associated with biliary obstruction, not upper GI bleeding.
C. Watery stool can be caused by various conditions, including infections, inflammatory bowel diseases, and medications. It is not a specific indicator of upper GI bleeding.
D. Bright red blood in the stool is more likely to be associated with lower GI bleeding, such as from hemorrhoids or anal fissures.

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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

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