A client with chronic obstructive pulmonary disease (COPD) is experiencing tachypnea and dyspnea. The nurse should plan to implement which of the following interventions to reduce bronchiolar collapse and air-trapping?

Instruct the client on pursed-lip breathing

Place the client in Trendelenburg position

Apply a high-frequency chest wall oscillation vest

Determine the client's FEV1/FVC ratio

Answer and Explanation

The Correct Answer is A

A.   Pursed-lip breathing is an effective technique for managing COPD symptoms, particularly tachypnea and dyspnea. It helps to keep the airways open by creating back pressure that prevents the collapse of bronchioles and reduces air-trapping. This technique improves ventilation and helps with the expiration of trapped air, making it a valuable intervention for COPD patients.
B.   The Trendelenburg position involves lying flat on the back with the legs elevated higher than the head. This position is not suitable for managing COPD symptoms and can actually worsen breathing difficulties by increasing abdominal pressure on the diaphragm.
C.   High-frequency chest wall oscillation (HFCWO) vests are used to help with airway clearance in conditions like cystic fibrosis or chronic bronchitis by loosening mucus. While beneficial for mucus management, they do not specifically address bronchiolar collapse or air-trapping associated with COPD.
D.   Measuring the FEV1/FVC ratio is a diagnostic tool used to assess the severity of airflow obstruction in COPD. While this information is important for diagnosis and treatment planning, it is not an immediate intervention to manage symptoms such as tachypnea and dyspnea.

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Correct Answer is D

Explanation

A. Ethnicity alone is not a known risk factor for ALS. ALS has a relatively uniform incidence across different ethnic groups. Studies have not demonstrated a significant correlation between ALS and being of Asian descent specifically.

B. There is limited evidence suggesting that consuming well water could be associated with an increased risk of ALS, particularly if the well water is contaminated with certain toxins or heavy metals. However, this is not a widely established risk factor and is less directly linked to ALS compared to other known risk factors.
C. Working in agriculture has been identified as a potential risk factor for ALS. Agricultural workers are often exposed to various environmental toxins, pesticides, and herbicides, which have been associated with an increased risk of developing ALS. This occupational exposure is considered a significant risk factor for the disease.
D. Military veterans are known to have an increased risk of developing ALS. Several studies have shown that veterans, particularly those who served in combat or were exposed to specific environmental hazards during their service, have a higher incidence of ALS compared to the general population.

A. Hemoglobin B. Platelets C. Blood urea nitrogen (BUN) D. B-type natriuretic peptide (BNP)

Correct Answer is D

Explanation

A. Hemoglobin levels measure the oxygen-carrying capacity of the blood. A reduced ejection fraction (30%) is more closely related to heart failure or significant cardiac dysfunction, which is not directly indicated by changes in hemoglobin levels.
B. Platelet levels are primarily involved in blood clotting and are less directly related to ejection fraction. Elevated or decreased platelet counts are not typically used as indicators of heart failure severity or reduced ejection fraction.
C. In cases of severe heart failure with a reduced ejection fraction, you may see elevated BUN levels due to these effects. However, it is not directly related to heart failure.
D. BNP is a hormone released by the heart in response to increased pressure and volume overload, typically seen in heart failure. Elevated BNP levels are associated with worsening heart failure and can be elevated in patients with a reduced ejection fraction. In heart failure, especially with an ejection fraction as low as 30%, BNP levels are often significantly elevated.

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A client with chronic obstructive pulmonary disease (COPD) is experiencing tachypnea and dyspnea. The nurse should plan to implement which of the following interventions to reduce bronchiolar collapse and air-trapping?

Nursing Test Bank

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Correct Answer is D

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