A nurse cares for a client with chronic obstructive pulmonary disease (COPD). The client states that going out with friends is no longer enjoyable.
How would the nurse respond?
There are a variety of support groups for people who have COPD.
I will ask your primary health care provider to prescribe an antianxiety agent.
I'd like to hear about thoughts and feelings causing you to limit social activities.
Friends can be a good support system for clients with chronic disorders.
The Correct Answer is C
Choice A rationale
While support groups can be beneficial, this response is premature and dismisses the client's immediate emotional expression. It focuses on a generalized solution rather than exploring the client's individual feelings and the specific reasons for their social withdrawal. Understanding the underlying psychological impact of chronic illness is crucial for providing person-centered care.
Choice B rationale
Prescribing medication is outside the nurse's scope of practice. Furthermore, immediately suggesting an antianxiety agent without a comprehensive assessment of the client's mental and emotional state can mask the true source of their distress and prevent exploration of coping mechanisms or other interventions.
Choice C rationale
This therapeutic communication technique prioritizes active listening and allows the client to elaborate on their feelings and experiences. It demonstrates empathy and respect, fostering a trusting relationship. Understanding the client's perspective is fundamental to developing an individualized and effective care plan for managing the psychosocial challenges of COPD.
Choice D rationale
While friends can offer support, this statement generalizes and might not be relevant to the client's specific situation. It also shifts the focus away from the client's internal experience and onto external factors, potentially minimizing their current distress and the impact of their condition on social engagement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D"]
Explanation
Choice A rationale
Stuffed toys can accumulate dust mites, which are common allergens for individuals with asthma. Exposure to these allergens can trigger bronchospasm, inflammation of the airways, and exacerbate asthma symptoms, leading to respiratory distress. Therefore, minimizing exposure by discouraging stuffed toys helps prevent asthma attacks.
Choice B rationale
Pet ownership, particularly of animals with fur or dander, can introduce significant allergens into the home environment. Proteins in pet dander, saliva, and urine can trigger allergic reactions and asthma symptoms in sensitized individuals. Avoiding pet ownership is a key strategy for reducing allergen exposure and managing asthma effectively.
Choice C rationale
Gymnastics, a high-intensity physical activity, can often induce exercise-induced bronchoconstriction in individuals with asthma. The rapid breathing during strenuous exercise can lead to airway cooling and drying, triggering narrowing of the airways and symptoms such as coughing, wheezing, and shortness of breath.
Choice D rationale
Basketball is an activity characterized by intermittent high-intensity exertion, which can readily trigger exercise-induced bronchoconstriction in asthmatic individuals. The sudden bursts of activity and rapid breathing patterns contribute to airway cooling and drying, leading to an increased risk of acute asthma symptoms during or after play.
Choice E rationale
Cotton blankets are generally considered hypoallergenic and are less likely to harbor dust mites compared to synthetic materials or wool. Cotton is breathable and can be washed frequently at high temperatures, which helps to eliminate allergens. Therefore, discouraging cotton blankets would be counterproductive to asthma management.
Correct Answer is ["B","C","D","E"]
Explanation
Choice A rationale
"What color is your sputum?" is a question related to the presence of infection or inflammation within the respiratory tract, providing insight into the nature of respiratory secretions. While important for overall respiratory assessment in COPD, it does not directly evaluate the client's functional capacity or activity tolerance.
Choice B rationale
"Do you have any difficulty sleeping?" directly assesses the impact of respiratory symptoms on rest and activity. Dyspnea, especially nocturnal or exertional dyspnea, can significantly impair sleep quality, indicating reduced activity tolerance and the inability of the respiratory system to meet oxygen demands during rest.
Choice C rationale
"How long does it take to perform your morning routine?" evaluates the client's ability to perform activities of daily living (ADLs). A prolonged duration or increased effort required for self-care tasks indicates diminished activity tolerance due to respiratory limitations, reflecting the physiological burden of COPD on daily functioning.
Choice D rationale
"Do you walk upstairs every day?" directly probes the client's capacity for common exertional activities. Walking upstairs is a standardized measure of functional exercise tolerance, and difficulty with this task signifies impaired respiratory reserve and reduced activity tolerance in individuals with chronic obstructive pulmonary disease.
Choice E rationale
"Have you lost any weight lately?" assesses nutritional status and systemic effects of chronic illness, often indicating the increased metabolic demands of breathing in COPD. While important for overall health, weight loss itself is not a direct measure of activity tolerance, but rather a consequence of severe disease progression.
Choice F rationale
"How does your activity compare to this time last year?" provides a valuable longitudinal perspective on the progression of COPD and the client's functional decline or stability. This comparison helps to quantify changes in activity tolerance over time, reflecting the effectiveness of treatment or disease progression.
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