A nurse is planning care for a patient with emphysema. Which of the following is a primary focus?
Optimizing gas exchange
Managing acute infections
Controlling chest pain
Reducing fluid overload
The Correct Answer is A
A. Optimizing gas exchange: Emphysema involves the irreversible destruction of alveolar walls and permanent enlargement of air spaces, which severely impairs the surface area for gas exchange. The primary goal of care is to maximize the patient's ability to oxygenate tissues and remove carbon dioxide. This addresses the core pathophysiological defect of the disease.
B. Managing acute infections: While emphysema patients are prone to secondary infections, the primary chronic focus is on respiratory mechanics and gas exchange. Infection management is a periodic necessity rather than the defining daily goal of care for emphysema. The plan of care focuses on long-term pulmonary rehabilitation.
C. Controlling chest pain: Chest pain is not a hallmark symptom of emphysema; rather, patients experience dyspnea and air hunger. If chest pain occurs, it may indicate a complication like a spontaneous pneumothorax or myocardial ischemia. It is not the primary focus of standard emphysema management.
D. Reducing fluid overload: Fluid overload is more characteristic of right-sided heart failure (cor pulmonale) or renal failure. While emphysema can lead to heart failure, the initial and primary focus remains on the lung parenchyma and gas exchange. Fluid management is a secondary concern related to potential cardiovascular complications.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Antibiotics to eliminate infection and improve airway clearance:Respiratory Syncytial Virus (RSV) is a viral pathogen, and antibiotics are ineffective against viruses. Using them without evidence of a secondary bacterial infection is inappropriate and does not assist in clearing thick mucus. The management of RSV is primarily supportive and focused on symptoms.
B. Antitussives to suppress coughing and improve rest:Coughing is a vital protective mechanism for clearing the thick, obstructive mucus seen in RSV bronchiolitis. Suppressing the cough reflex can lead to worsening mucus plugging and increased respiratory distress. Antitussives are generally contraindicated in conditions characterized by heavy secretions.
C. Decongestants to relieve nasal congestion and promote mucus clearance:Decongestants target upper airway edema but are not effective for the lower airway mucus production seen in RSV. They do not significantly thin thick secretions or improve the diameter of the bronchioles. Their role is limited in the management of pediatric bronchiolitis.
D. Mucolytics to thin and loosen mucus:Mucolytic agents work by breaking down the chemical bonds in thick respiratory secretions to reduce their viscosity. This allows the patient to expectorate the mucus more easily, thereby improving airway patency and gas exchange. This class specifically addresses the mechanical obstruction caused by RSV.
Correct Answer is C
Explanation
A. Increased reliance on untested medications:Evidence-based practice (EBP) specifically seeks to eliminate the use of untested or unproven therapies. It mandates that all interventions be supported by rigorous scientific data and clinical trials. This increases patient safety by ensuring that medications have a proven efficacy and safety profile.
B. Increased use of trial-and-error methods:Trial-and-error is the antithesis of EBP, as it relies on unsystematic attempts rather than proven research. EBP reduces the uncertainty of clinical decision-making by providing a structured framework based on the best available data. It moves nursing away from guesswork toward standardized, high-quality care.
C. Improvement in patient outcomes and care quality:By utilizing interventions that have been scientifically validated, EBP ensures that patients receive the most effective treatments available. This leads to faster recovery times, fewer complications, and a higher standard of clinical excellence. It is the primary driver of modern healthcare improvement.
D. Reduction in healthcare costs only:While EBP can lead to cost savings by reducing ineffective treatments and hospital stays, its primary focus is on the quality of patient care. Financial benefits are a secondary positive outcome of improved clinical efficiency. The core benefit remains the enhancement of the patient's health and safety.
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