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

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

"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"

Answer and Explanation

The Correct Answer is B

A.   Pursed-lip breathing does not require a specific body position, but it is often more comfortable and effective when the patient is in a semi-Fowler’s position (elevated head of the bed) or sitting upright. Being flat on the back might actually make breathing more difficult for some patients with COPD.
B.   The technique involves inhaling slowly through the nose and exhaling through pursed lips, which creates a slight resistance during expiration. This helps to keep the airways open longer, reduce airway collapse, and improve oxygen exchange. Proper inhalation and exhalation technique are key components of effective pursed-lip breathing.
C.   In pursed-lip breathing, expiration should be longer than inspiration. The recommended pattern is to inhale slowly through the nose for about 2 counts and then exhale slowly through pursed lips for about 4 counts. The extended expiration phase helps to remove trapped air from the lungs and improves overall ventilation.
D.   Coughing forcefully is not a part of pursed-lip breathing. Pursed-lip breathing focuses on controlled breathing to improve airflow and ease breathing. Coughing can be done separately if needed, but it is not a component of the pursed-lip breathing technique.

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Correct Answer is C

Explanation

A. This is a good method to gather feedback but does not directly assess the client's ability to perform the taught skills.
B. This is important to identify knowledge gaps but does not assess the client's ability to perform the skills.
C. This is the most direct way to assess the client's ability to perform the taught skill and ensures that the client has retained the information.
D. While important, vital signs do not directly assess the effectiveness of home care teaching.

A. Infuse 0.9% sodium chloride. B. Stop the transfusion. C. Return the unit of blood to the blood bank D. Obtain a blood sample from the client.

Correct Answer is B

Explanation

A. While administering 0.9% sodium chloride is an important step to maintain venous access and to help dilute any blood that might still be in the tubing, it is not the first action to take if a transfusion reaction is suspected. This step should occur after the transfusion is stopped and the patient’s safety is ensured.
B. The immediate priority when a transfusion reaction is suspected is to stop the transfusion immediately. This action helps to prevent further exposure to the potentially harmful blood product and mitigates the risk of worsening the reaction. Stopping the transfusion also allows for prompt medical assessment and intervention.
C. Returning the unit of blood to the blood bank is important for investigation and to determine the cause of the reaction, but it should be done after stopping the transfusion and ensuring the client’s safety. The blood bank may require the returned unit to confirm any issues with the blood product.

D. Obtaining a blood sample from the client is crucial for diagnostic purposes and to identify the cause of the reaction, but this should be done after the transfusion has been stopped. The sample may help in diagnosing the type of reaction or in managing it, but it does not address the immediate safety concerns.

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A nurse is teaching 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

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