The nurse observes an adult client perform a return demonstration of diaphragmatic breathing. The client inhales while holding the abdomen, then removes the hand to allow expansion of the abdomen during exhalation. Which action should the nurse take after observing the client’s demonstration?

Remind the client to keep light pressure on the abdomen and cough after fully exhaling.

Confirm that the breathing technique was correct but hand pressure is not necessary.

Document that the client successfully demonstrated the diaphragmatic breathing technique.

Demonstrate how to expand the abdomen while inhaling and let it relax while exhaling.

Answer and Explanation

The Correct Answer is D

Choice A reason: Keeping pressure on the abdomen and coughing is incorrect for diaphragmatic breathing, which enhances lung expansion, not airway clearance. Coughing is for post-drainage. The client’s incorrect technique (abdominal expansion on exhalation) requires correction, as this reverses mechanics, reducing ventilation efficiency in conditions like COPD.

Choice B reason: The client’s technique is incorrect, expanding the abdomen on exhalation, not inhalation, reducing diaphragmatic efficacy. Confirming it as correct is wrong, as it impairs lung expansion. Demonstrating proper technique corrects the error, ensuring effective breathing to improve oxygenation, addressing the physiological need for ventilation.

Choice C reason: Documenting success is inaccurate, as the client’s technique is reversed, expanding the abdomen on exhalation. Diaphragmatic breathing requires inhalation expansion to lower the diaphragm, increasing lung capacity. Correcting the technique via demonstration ensures proper mechanics, not documenting an ineffective method that hinders ventilation.

Choice D reason: Demonstrating proper diaphragmatic breathing corrects the client’s error of exhalation expansion. Inhaling expands the abdomen via diaphragmatic descent, increasing tidal volume; exhaling relaxes it. This optimizes ventilation, addressing the need for effective breathing in conditions requiring enhanced lung function, ensuring the client learns the correct technique.

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Correct Answer is A

Explanation

Choice A reason: Avolition in schizophrenia is lack of motivation for goal-directed tasks, linked to prefrontal dopamine deficits. Performing activities of daily living (e.g., hygiene) shows improved motivation, achieving the goal. This reflects enhanced frontal lobe function, addressing the negative symptom of avolition, critical for functional recovery in schizophrenia.

Choice B reason: Explaining answers to open-ended questions shows cognitive ability, not motivation. Avolition impairs initiative for tasks like self-care, not verbal skills. Schizophrenia’s negative symptoms reduce drive, and this behavior does not address the motivational deficit targeted, making it less relevant than performing daily activities.

Choice C reason: Reporting enjoyment suggests improved affect but not motivation. Avolition involves initiating tasks, not emotional response. Performing daily activities directly demonstrates overcoming avolition, a negative symptom of reduced drive, aligning with the goal of enhancing goal-directed behavior in schizophrenia, making this less indicative.

Choice D reason: Sharing a story indicates social engagement, impaired in schizophrenia but not specific to avolition, which affects motivation for routine tasks. Performing daily activities directly shows improved initiative, addressing the treatment goal’s focus on overcoming dopamine-related motivational deficits, making social sharing less relevant.

A. Dry skin with inelastic turgor. B. Apical rate of 110 beats/minute. C. Serum sodium of 185 mEq/L (185 mmol/L). D. Polyuria and excessive thirst.

Correct Answer is C

Explanation

Choice A reason: Dry skin and inelastic turgor reflect dehydration in DI from antidiuretic hormone deficiency, causing water loss. This is less urgent than hypernatremia (185 mEq/L), which dehydrates brain cells, risking seizures or coma, requiring immediate fluid correction to prevent neurological damage in this critical condition.

Choice B reason: Tachycardia (110 beats/minute) compensates for hypovolemia in DI, where water loss reduces preload, triggering sympathetic activation. This is less critical than hypernatremia (185 mEq/L), which causes cerebral dehydration, necessitating urgent hypotonic fluids to prevent neurological complications, making heart rate secondary.

Choice C reason: Serum sodium of 185 mEq/L indicates severe hypernatremia in DI, where water loss concentrates sodium, dehydrating neurons and risking seizures or coma. Immediate IV hypotonic fluids (e.g., 5% dextrose) correct osmolarity, preventing life-threatening cerebral complications, addressing the urgent pathophysiological crisis in DI.

Choice D reason: Polyuria and thirst are hallmark DI symptoms from water loss but expected and less urgent than hypernatremia (185 mEq/L), which threatens neurological function via osmotic brain injury. Correcting sodium is critical to prevent seizures, making these symptoms secondary to urgent electrolyte management.

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The nurse observes an adult client perform a return demonstration of diaphragmatic breathing. The client inhales while holding the abdomen, then removes the hand to allow expansion of the abdomen during exhalation. Which action should the nurse take after observing the client’s demonstration?

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Naxlex Comprehensive Predictor Exams

The mental health team working with a homeless client with chronic schizophrenia establishes the treatment goal of, “Improvement in avolition prior to discharge.” Which behavior demonstrates achievement of this goal to the nurse?

Correct Answer is A

Explanation

Which data warrants the most immediate intervention by the nurse for a client with diabetes insipidus (DI)? Reference Range: Sodium [136 to 145 mEq/L (136 to 145 mmol/L)].

Correct Answer is C

Explanation

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