A nurse is caring for a young patient on a ventilator with no brain activity.

The physician discusses options with the family, one of which is removing life support and allowing the patient to die.

The nurse recognizes a decisional conflict related to religious beliefs and treatment options.

The nurse utilizes the HOPE Tool for spiritual assessment.

Which question is NOT part of the HOPE Tool?

Pursed-lip breathing is a technique that helps to slow down the breathing rate and keep the airways open longer. This improves gas exchange and reduces the work of breathing. Pursed-lip breathing also helps to prevent air trapping and hyperinflation of the lungs, which are common complications of COPD.

Choice B is wrong because laying down for 1 hour after meals can increase the pressure on the diaphragm and make breathing more difficult. It can also increase the risk of aspiration and reflux.

Choice C is wrong because restricting the client’s fluid intake to less than 1 L/day can lead to dehydration and thickening of secretions, which can obstruct the airways and impair gas exchange. Fluid intake should be adequate to maintain hydration and thin secretions.

Choice D is wrong because using the upper chest for respiration is a sign of inefficient breathing and respiratory distress.

It can increase the oxygen demand and cause fatigue. The client should be encouraged to use the diaphragm and abdominal muscles for respiration, which are more efficient and reduce the work of breathing.

Normal ranges for oxygen saturation are 95% to 100%, for arterial blood gas pH are 7.35 to 7.45, for PaCO2 are 35 to 45 mmHg, for PaO2 are 80 to 100 mmHg, and for HCO3 are 22 to 26 mEq/L.

According to Mayo Clinic, physical therapy and exercises can improve strength, flexibility and stamina for people with fibromyalgia.

Low-impact aerobics, such as swimming or biking, are recommended as they are less likely to cause muscle soreness or injury.

Choice A is wrong because antidepressant medications can help ease the pain and fatigue associated with fibromyalgia.

They are often prescribed as part of the treatment plan.

Choice B is wrong because physical manifestations of the disease do not become progressively worse despite treatment.

Fibromyalgia is a chronic condition, but it does not damage the joints, muscles or organs.

Choice D is wrong because narcotic analgesia will not be used for long-term pain control. Opioid medications can cause significant side effects and dependence and will worsen the pain over time.

They are not recommended for fibromyalgia treatment.