What is the underlying rationale for why a nurse assesses a client with emphysema for clinical indicators of hypoxia?
Increased mucus production blocks the alveoli
Infections decrease ventilation
Lack of adequate surface area for aeration
Inflammation of the bronchioles decreases breathing capacity
The Correct Answer is C
A. Increased mucus production blocking the alveoli is incorrect. While mucus production can be an issue in COPD, it is more characteristic of chronic bronchitis rather than emphysema.
B. Infections decreasing ventilation is incorrect. Although infections can worsen emphysema symptoms, they are not the primary cause of chronic hypoxia in these clients.
C. Lack of adequate surface area for aeration is correct. Emphysema leads to alveolar destruction and loss of elasticity, reducing the surface area available for gas exchange, which causes chronic hypoxia.
D. Inflammation of the bronchioles decreasing breathing capacity is incorrect. While airway inflammation is seen in conditions like asthma and chronic bronchitis, emphysema is primarily characterized by alveolar damage rather than airway inflammation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Crossing the legs can actually increase the risk of venous stasis and clot formation, which can lead to a pulmonary embolism. The client needs further teaching to avoid this habit.
B. Smoking increases the risk of blood clot formation, so quitting smoking is an appropriate preventive measure.
C. Staying hydrated helps maintain good blood flow and reduces the risk of clot formation.
D. Regular exercise and weight management help prevent venous stasis and clot formation, lowering the risk of pulmonary embolism.
Correct Answer is B
Explanation
A. Stress testing evaluates cardiac function and ischemia but is not used to diagnose a pulmonary embolism (PE).
B. D-Dimer is correct. D-Dimer is a blood test that detects fibrin degradation products, which are elevated when a blood clot forms and breaks down, making it a useful screening test for pulmonary embolism. However, a positive D-Dimer is not diagnostic, and further imaging (e.g., CT pulmonary angiography) is required.
C. Electrocardiogram (ECG) may show changes (e.g., sinus tachycardia, right heart strain) but does not confirm PE.
D. Pulmonary function testing assesses lung diseases like COPD or asthma but is not used to diagnose PE.
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