A client diagnosed with emphysema states that it is uncomfortable to sit in a semi-Fowler's position. In order to best decrease the work of breathing, the nurse should assist the client to:

Move into a side-lying position with the head elevated.

Lay in the Trendelenburg position.

Lean over the bedside table.

Sit in Fowler's position with heels off the bed.

Answer and Explanation

The Correct Answer is C

Choice A Reason:
A side-lying position with the head elevated may provide some comfort but is not the most effective position for reducing the work of breathing in emphysema patients. This position does not maximize lung expansion or aid in the optimal use of respiratory muscles.

Choice B Reason:
The Trendelenburg position, where the body is laid flat on the back with the feet higher than the head, is not recommended for emphysema patients as it can increase the pressure on the diaphragm, making breathing more difficult.

Choice C Reason:
Leaning over the bedside table, often referred to as the tripod position, is beneficial for emphysema patients. This position allows for the optimal use of respiratory muscles and helps to reduce the work of breathing by supporting the arms and allowing the shoulder girdle muscles to assist in the breathing process.

Choice D Reason:
Fowler's position, where the patient is seated with the legs either bent or straight out in front, may not be as effective as the tripod position for emphysema patients. While it does allow for better lung expansion than lying flat, it does not provide the same level of support for the respiratory muscles as leaning forward does.

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Correct Answer is A

Explanation

Choice A reason:

Post-operative pain management is a critical aspect of care for a client recovering from a below-the-knee amputation. Administering pain medication as needed helps to manage pain effectively, which is essential for the client's comfort and recovery. Pain control is also important to facilitate participation in rehabilitation activities.

Choice B reason:

It is not advisable to encourage the client to bear weight on the affected limb immediately after surgery. The residual limb needs time to heal, and premature weight-bearing can lead to complications such as delayed healing or wound dehiscence.

Choice C reason:

While it is important to prevent complications such as deep vein thrombosis, complete restriction of mobility and keeping the client on bed rest is not recommended. Early mobilization, as part of a rehabilitation program, is essential for improving circulation, preventing muscle atrophy, and promoting overall recovery.

Choice D reason:

Applying a tight compression bandage on the residual limb is a common practice in the post-operative care of clients with amputations. The compression bandage helps to control swelling, shape the limb for a prosthesis, and prevent fluid accumulation. However, the bandage must be applied correctly to avoid impairing circulation.

A. Abdominal distention B. Hypoactive bowel sounds C. Diarrhea D. Fever

Correct Answer is A

Explanation

Choice A Reason:
Abdominal distention is a common finding in large bowel obstruction due to the accumulation of intestinal contents, gas, and fluid proximal to the obstruction site. This can lead to a visibly swollen abdomen and is often accompanied by discomfort or pain.

Choice B Reason:
Hypoactive bowel sounds are expected in large bowel obstruction as the peristaltic activity decreases below the point of obstruction. Initially, bowel sounds may be high-pitched or tinkling due to the intestine's attempt to move contents past the obstruction, but as the condition progresses, the sounds become less frequent or even absent.

Choice C Reason:
Diarrhea is not typically associated with large bowel obstruction. In fact, constipation or cessation of stool is a more common symptom. If diarrhea occurs, it may be due to a partial obstruction or the presence of liquid stool that can pass around the blockage.

Choice D Reason:
Fever may indicate a complication of large bowel obstruction, such as ischemia or perforation, leading to infection and inflammation. However, fever is not a primary symptom of uncomplicated large bowel obstruction and should prompt immediate further investigation.

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A client diagnosed with emphysema states that it is uncomfortable to sit in a semi-Fowler's position. In order to best decrease the work of breathing, the nurse should assist the client to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which nursing action(s) should the nurse include in the post-op plan of care for a client recovering from a below-the-knee amputation?

Correct Answer is A

Explanation

A client is diagnosed with a large bowel obstruction. Which assessment findings by the nurse would be expected?

Correct Answer is A

Explanation

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