A nurse is reinforcing teaching with a client who has COPD about purse-lipped breathing. Which of the following statements should the nurse make?

"You should inhale through your nose and exhale through your mouth during purse-lipped breathing."

"Your inspiration should be longer than expiration during purse-lipped breathing."

"You should cough forcefully during exhalation when you are purse-lipped breathing."

"You should be flat on your back when you perform purse-lipped breathing."

Answer and Explanation

The Correct Answer is A

A. "You should inhale through your nose and exhale through your mouth during purse-lipped breathing."

Pursed-lip breathing is a breathing technique commonly used by individuals with COPD to help improve breathing efficiency and manage dyspnea (shortness of breath). During purse-lip breathing, the individual inhales slowly through the nose and exhales slowly and gently through pursed lips, creating a slight resistance to the airflow. This technique helps to keep the airways open longer during exhalation, reduces air trapping, and improves oxygenation.

B. "Your inspiration should be longer than expiration during purse-lipped breathing."

Pursed-lip breathing typically involves making both the inspiration and expiration longer than usual. The focus is on slowing down the breathing rate and extending the exhalation phase to promote better gas exchange and reduce respiratory effort.

C. "You should cough forcefully during exhalation when you are purse-lipped breathing."

Pursed-lip breathing is a gentle breathing technique used to promote relaxation and control of breathing. Forceful coughing during exhalation is not part of purse-lip breathing and may not be appropriate, especially for individuals with COPD who are prone to airway irritation and bronchospasm.

D. "You should be flat on your back when you perform purse-lipped breathing."

The position for performing purse-lip breathing is not specific to lying flat on the back. Individuals can perform purse-lip breathing in various positions that are comfortable and allow for effective breathing, such as sitting upright or leaning slightly forward. The key is to find a position that facilitates relaxation and optimal lung expansion.

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Correct Answer is B

Explanation

A. Prone with arms raised over the head.

This position involves lying face down with the arms raised over the head. It is not appropriate for thoracentesis because it does not provide easy access to the thoracic cavity, and it may compress the chest, making it difficult for the client to breathe comfortably during the procedure.

B. Sitting, leaning forward over the bedside table.

This is the correct choice. For thoracentesis, the client should be positioned sitting upright and leaning forward over the bedside table or supported by pillows. This position allows better access to the thoracic cavity and facilitates the removal of pleural fluid. Leaning forward also helps to open up the intercostal spaces, making it easier for the healthcare provider to insert the needle into the appropriate space between the ribs.

C. High Fowler's position.

The High Fowler's position involves the client sitting upright with the head of the bed elevated at a 90-degree angle. While this position may be used for other respiratory procedures or for comfort, it is not the optimal position for thoracentesis. It does not provide the same degree of access to the thoracic cavity as the sitting position with forward leaning.

D. Side-lying with knees drawn up to the chest.

This position involves lying on one side with the knees drawn up to the chest. It is not appropriate for thoracentesis because it does not provide access to the thoracic cavity, and it may obstruct the procedure. Additionally, this position may not be comfortable for the client during the procedure.

A. Start slowly and increase volume over several sessions. B. Do regular deep-breathing exercises instead. C. Use another device because this one is might be faulty. D. Be much more vigorous in increasing increments.

Correct Answer is A

Explanation

A. Start slowly and increase volume over several sessions.

This is the correct choice. For clients having difficulty using an incentive spirometer, starting slowly and gradually increasing the volume over several sessions is an appropriate approach. It allows the client to become familiar with the device and the technique required for effective use. Starting slowly also reduces the risk of discomfort or respiratory distress, allowing the client to build up their lung capacity gradually and achieve optimal results over time.

B. Do regular deep-breathing exercises instead.

Regular deep-breathing exercises are beneficial for improving lung function and respiratory strength. However, using an incentive spirometer serves a specific purpose in promoting deep breathing and lung expansion to prevent atelectasis (lung collapse) and improve respiratory function. While deep-breathing exercises are helpful, they may not provide the same targeted benefits as using an incentive spirometer, especially for clients who are experiencing difficulty with deep breathing or lung expansion.

C. Use another device because this one might be faulty.

This option assumes that the difficulty with the incentive spirometer is due to a fault in the device itself, which may not necessarily be the case. Before considering another device, it's important to ensure that the client is using the current device correctly and receiving proper instruction. If the client continues to have difficulty despite proper technique and instruction, then further assessment of the device may be warranted.

D. Be much more vigorous in increasing increments.

Being much more vigorous in increasing increments is not recommended, as it could lead to discomfort, respiratory distress, or hyperventilation for the client. Increasing the volume too quickly may overwhelm the client and make it more difficult for them to use the incentive spirometer effectively. Gradual progression allows the client to adjust to the device and build up their lung capacity safely and effectively over time.

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A nurse is reinforcing teaching with a client who has COPD about purse-lipped breathing. Which of the following statements should the nurse make?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is scheduled to undergo thoracentesis. In which of the following positions should the nurse place the client for the procedure?

Correct Answer is B

Explanation

A nurse is reinforcing teaching with a client who is having difficulty using an incentive spirometer. Which of the following instructions should the nurse include in the teaching?

Correct Answer is A

Explanation

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