A nurse is performing a focused assessment on a client who has a history of COPD and is experiencing dyspnea. Which of the following findings should the nurse expect?
Pulse oximetry reading of 95%
Decreased depth of respirations
Flaring of the nostrils
Respiratory rate of 16/min
The Correct Answer is C
A. Pulse oximetry reading of 95%. COPD clients often have lower baseline oxygen levels (88-92%), making this reading unexpectedly high.
B. Decreased depth of respirations. COPD typically causes shallow and rapid breathing due to air trapping.
C. Flaring of the nostrils: Nostril flaring is a sign of increased respiratory effort, which is common in COPD exacerbations.
D. Respiratory rate of 16/min. → Normal range (12-20/min), not an expected finding during dyspnea.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
A. Smoking – Smoking increases the risk of colorectal cancer and can be changed.
B. Alcohol consumption – Alcohol use increases cancer risk and is modifiable.
C. Inflammatory bowel disease – This is a non-modifiable risk factor.
D. High-fat diet – Dietary habits can be changed to lower the risk.
E. Colorectal polyps – Polyps are a non-modifiable risk factor.
Correct Answer is B
Explanation
A. "Hold your breath for 6 seconds after inhaling the medication." – The correct recommendation is to hold the breath for at least 10 seconds to allow maximum medication absorption in the lungs.
B. "Inhale the medication deeply for 5 seconds." – A slow, deep inhalation (3-5 seconds) allows the medication to reach the lower airways effectively.
C. "Do not shake the medication in the inhaler." – Most metered-dose inhalers (MDIs) need to be shaken before use to ensure proper mixing of medication. Exceptions include dry powder inhalers (DPIs), which should not be shaken.
D. "Hold the inhaler 3 inches away from your mouth." – The correct distance is 1 to 2 inches (2-4 cm) from the mouth, or the mouthpiece can be placed directly into the mouth with lips sealed around it.
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