A nurse assesses a client’s respiratory status. Which observation indicates that the client is having difficulty breathing?
Diaphragmatic breathing
Controlled breathing
Pursed-lip breathing
Use of accessory muscles
The Correct Answer is D
A. Diaphragmatic breathing:
Diaphragmatic breathing, also known as abdominal or deep breathing, is a normal and effective way of breathing. It involves the contraction and relaxation of the diaphragm, allowing for efficient lung expansion. This is a healthy and efficient breathing technique.
B. Controlled breathing:
Controlled breathing refers to a deliberate and regulated breathing pattern. It can include techniques such as paced breathing, where the individual consciously controls the rate and depth of their breaths. Controlled breathing is generally considered a positive and intentional approach to managing respiratory function.
C. Pursed-lip breathing:
Pursed-lip breathing is a breathing technique where the individual breathes in through the nose and exhales through pursed lips. This method is often taught to individuals with certain respiratory conditions, such as chronic obstructive pulmonary disease (COPD), to help improve lung function and alleviate shortness of breath. Pursed-lip breathing can be a helpful strategy in specific situations.
D. Use of accessory muscles:
The use of accessory muscles indicates that the person is experiencing increased difficulty in breathing. Accessory muscles, such as the neck and shoulder muscles, are not typically heavily involved in breathing under normal circumstances. When these muscles are visibly working during breathing, it suggests increased respiratory effort and can be a sign of respiratory distress or difficulty.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["4"]
Explanation
Warfarin (Coumadin) is an anticoagulant medication that prevents blood clots from forming or growing larger. It is prescribed for clients who have atrial fibrillation, deep vein thrombosis, pulmonary embolism, or artificial heart valves.
The physician orders warfarin 10 mg PO to be administered to a client at 1800 today. The pharmacy only has 2.5 mg tablets available. To calculate the number of tablets that the nurse will administer, the nurse will divide the ordered dose by the available dose. The formula is:
Number of tablets = Ordered dose / Available dose
Number of tablets = 10 mg / 2.5 mg
Number of tablets = 4
Therefore, the nurse will administer 4 tablets of warfarin 2.5 mg PO to the client at 1800 today
Correct Answer is ["A","B","C","D"]
Explanation
Withhold food and oral fluids before the procedure
Withholding food and oral fluids before the procedure is essential to prevent complications during the cardiac catheterization. The client is typically NPO (nothing by mouth) for a specified period before the procedure.
B. Review medications the client has taken in the last 24 hours
Reviewing the client's medications is crucial to ensure that any medications affecting coagulation or blood vessels are appropriately managed before the cardiac catheterization.
C. Verify that written consent has been obtained
Verifying the presence of written consent is a critical step to confirm that the client has been adequately informed about the procedure, its risks, and benefits, and has given consent for the cardiac catheterization.
D. Check for iodine sensitivity
Checking for iodine sensitivity is important because iodinated contrast dye is commonly used during cardiac catheterization. Allergies or sensitivities to iodine contrast must be identified to prevent adverse reactions.
E. Administer all ordered oral medications
Administration of oral medications before the procedure depends on the specific medications and the healthcare provider's instructions. Some medications may be held, while others may be continued as prescribed.

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