The nurse is evaluating the effectiveness of the incentive spirometer implemented in the client's plan of care. Which outcome statement best describes the effectiveness of the incentive spirometer?

Client's breath sounds are clear to auscultation bilaterally.

Client exhibits a frequent productive cough.

Client demonstrates proper use of an incentive spirometer.

Client reports using the incentive spirometer every hour while awake.

Answer and Explanation

The Correct Answer is A

A.   Clear breath sounds indicate effective ventilation and oxygenation, which are the desired outcomes of incentive spirometry. This outcome directly reflects the effectiveness of the incentive spirometer in preventing atelectasis and improving lung expansion.
B.   A productive cough suggests mobilization of secretions. While this is important for airway clearance, it is not a direct measure of the effectiveness of the incentive spirometer. This outcome is related to airway clearance, but not specifically to the incentive spirometer's role in lung expansion.
C.   This outcome measures the client's ability to use the device correctly but does not assess the effectiveness of the device in improving lung function. This outcome is important but does not directly address the goal of the incentive spirometer.
D.   This outcome measures compliance with the therapy but does not assess its effectiveness in improving lung function. This outcome is important for adherence but does not directly address the goal of the incentive spirometer.

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Correct Answer is C

Explanation

A. Weight lifting can be beneficial for overall fitness, but for someone with chronic venous insufficiency, the focus should be on activities that improve venous return and avoid excessive strain on the legs. Heavy weight lifting might exacerbate symptoms or lead to further complications.
B. For individuals with chronic venous insufficiency, prolonged standing can worsen symptoms such as swelling and pain. It’s important to avoid standing for long periods and to use measures such as leg elevation and compression stockings to manage symptoms.
C. This statement reflects an understanding of good practices for managing chronic venous insufficiency. Sitting for prolonged periods and crossing the legs can impede venous return and worsen symptoms of CVI. It is advised to avoid these practices and instead frequently change positions, elevate the legs, and use compression stockings to improve circulation.
D. While getting help to walk a dog could be beneficial if the client is unable to walk or if walking exacerbates symptoms, this statement does not directly address key aspects of managing chronic venous insufficiency. Regular walking is generally recommended to enhance venous return and prevent complications, assuming it is done within the client’s tolerance and ability.

A. Pneumonia B. Lung cancer C. Flu D. Chronic obstructive pulmonary disease (COPD) E. Chronic bronchitis

Correct Answer is ["B","E"]

Explanation

A. Pneumonia is an acute infection that causes inflammation in the lungs. While it can lead to significant respiratory symptoms and changes, it is not typically associated with clubbed nails. Clubbing usually develops over a longer period and is more common in chronic conditions.
B. Clubbing of the nails is often associated with lung cancer, particularly with bronchogenic carcinoma. The exact mechanism is not entirely clear, but it may relate to the presence of a malignancy causing systemic changes or the release of growth factors that affect nail tissue.
C. The flu is a viral respiratory infection that is usually acute and self-limiting. Clubbed nails are not a common manifestation of influenza. Clubbing is more associated with chronic respiratory and systemic conditions rather than acute viral infections.
D. COPD, which includes emphysema and chronic bronchitis, is not commonly associated with clubbing.

E. Chronic bronchitis, a type of COPD characterized by persistent cough and sputum production, may lead to clubbed nails in some cases. The chronic hypoxemia and long-term inflammation can contribute to this nail change, although it is less commonly seen than with other conditions.

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The nurse is evaluating the effectiveness of the incentive spirometer implemented in the client's plan of care. Which outcome statement best describes the effectiveness of the incentive spirometer?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with chronic venous insufficiency is being discharged from the hospital, and plans to return home. Which client statement indicates an understanding of home care instructions?

Correct Answer is C

Explanation

Exhibits The nurse reviews client data. Select the 3 possible conditions that could have the clinical manifestation of clubbed nails for this client.

Correct Answer is ["B","E"]

Explanation

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