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?
Start slowly and increase volume over several sessions.
Do regular deep-breathing exercises instead.
Use another device because this one is might be faulty.
Be much more vigorous in increasing increments.
The Correct Answer is A
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. 1 day after injection with a 10-mm area of redness and swelling:
This may suggest a positive reading, but induration size is the primary criterion for interpretation, not just redness and swelling.
B. 2 days after injection with a 5-mm area of redness and swelling:
Similar to option A, a 5-mm area of redness and swelling alone does not definitively indicate a positive TB skin test. Again, without information on the size of the induration, we cannot determine if this reading is positive.
C. 4 days after injection with a 3-mm area of redness and swelling:
Once more, a 3-mm area of redness and swelling alone does not definitively indicate a positive TB skin test. As with the previous options, the size of the induration is the critical factor for interpretation.
D. 5 days after injection with a 2-mm area of redness and swelling:
As with the other options, a 2-mm area of redness and swelling alone does not definitively indicate a positive TB skin test. The presence and size of induration are essential for accurate interpretation.

Correct Answer is A
Explanation
A. Expiratory wheeze
Expiratory wheeze is a high-pitched, musical sound heard primarily during expiration. It occurs when air passes through narrowed airways due to bronchoconstriction, inflammation, and increased mucus production, which are characteristic features of an acute asthma exacerbation. Expiratory wheezes are commonly heard upon auscultation of the chest in individuals experiencing asthma exacerbations.
B. Pleural friction rub
Pleural friction rub is a dry, crackling or grating sound heard during both inspiration and expiration. It typically occurs when the inflamed pleural surfaces rub against each other during breathing. Pleural friction rub is associated with conditions such as pleurisy (inflammation of the pleura) or pleural effusion (accumulation of fluid in the pleural space), rather than asthma exacerbations.
C. Fine rales
Fine rales, also known as fine crackles, are brief, high-pitched, discontinuous sounds heard primarily during inspiration. They are typically associated with conditions involving the small airways and alveoli, such as pulmonary fibrosis or congestive heart failure. Fine rales are not commonly heard in asthma exacerbations.
D. Rhonchi
Rhonchi are low-pitched, snoring or rattling sounds heard primarily during expiration. They result from the passage of air through airways obstructed by thick mucus or secretions. While rhonchi may be heard in individuals experiencing asthma exacerbations, they are less characteristic than expiratory wheezes, which are more commonly associated with asthma exacerbations. Rhonchi are often associated with conditions such as chronic bronchitis or pneumonia.
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